Hatakeyama Tomoya, Sakai Kazuki, Komiyama Sosuke, Tamai Hidemasa, Ogino Shiro, Akami Toshikazu, Ueda Yuji, Mazaki Takeshi
Dept. of Surgery, Osaka General Hospital of West Japan Railway Company.
Gan To Kagaku Ryoho. 2020 Dec;47(13):2400-2402.
An 80-year-old women admitted to our hospital with jaundice. Abdominal contrast-enhanced CT scan revealed an enhanced tumor, measuring 10 mm, at the duodenal ampulla. Upper endoscopy showed a submucosal tumor-like lesion at the duodenal ampulla. Immunohistochemical findings showed positive for chromogranin A and synaptophysin, and neuroendocrine carcinoma was diagnosed. Subtotal stomach-preserving pancreaticoduodenectomy with regional lymph node dissection was performed. The final diagnosis was large cell neuroendocrine carcinoma(LCNEC). Multiple metastases of liver, lung and bone were occurred 14 months after the surgery, and she died 21 months after the surgery. LCNEC of the duodenal ampulla is very rare, and its prognosis is poor.
一名80岁女性因黄疸入住我院。腹部增强CT扫描显示十二指肠壶腹有一个10毫米的强化肿瘤。上消化道内镜检查显示十二指肠壶腹有一个黏膜下肿瘤样病变。免疫组化结果显示嗜铬粒蛋白A和突触素呈阳性,诊断为神经内分泌癌。行保留胃的胰十二指肠次全切除术并区域淋巴结清扫。最终诊断为大细胞神经内分泌癌(LCNEC)。术后14个月发生肝、肺和骨多发转移,术后21个月死亡。十二指肠壶腹LCNEC非常罕见,预后较差。