Fulfaro F, Quagliuolo V, De Conno F, Ripamonti C
Division of Pain Therapy and Palliative Care, National Cancer Institute, Milan, Italy.
Eur J Surg Oncol. 1998 Dec;24(6):601-4. doi: 10.1016/s0748-7983(98)93932-4.
Carcinoid somatostatinoma is a rare neuroendocrine malignant tumour and the duodenal location is an atypical site of presentation of which only few cases have been reported in the literature. A case of duodenal carcinoid somatostatinoma metastatic to lymph nodes in a 66-year-old patient is presented with an update of the literature. No relevant signs or symptoms were associated to the retrogastric lymph-node mass, which deformed but did not infiltrate the stomach wall. At the first and third portion of the duodenum, two polipoid endoluminal nodules (size 1 cm) were found with adjacent adenopathy partially adherent to the head of the pancreas and with thickening of the antropyloric wall. The patient underwent antrectomy duodenum mobilization and lymphadenectomy in the hepatic artery region. The treatment was successful and, over 3 years after diagnosis, there has been no clinical or radiological evidence of relapse. Duodenal somatostatinoma is rare and its diagnosis is often incidental. Surgery would be the appropriate treatment in the early stage of the disease with good chances of cure.
类癌性生长抑素瘤是一种罕见的神经内分泌恶性肿瘤,十二指肠部位是其非典型的发病部位,文献中仅报道过少数病例。本文报告了一例66岁患者发生十二指肠类癌性生长抑素瘤并转移至淋巴结的病例,并对相关文献进行了更新。胃后淋巴结肿块未伴有相关体征或症状,该肿块使胃壁变形但未浸润胃壁。在十二指肠第一和第三部分发现两个息肉样腔内结节(大小为1厘米),伴有相邻的淋巴结肿大,部分与胰头粘连,胃窦壁增厚。患者接受了胃窦切除术、十二指肠游离术以及肝动脉区域淋巴结清扫术。治疗取得成功,诊断后3年多来,无临床或影像学复发证据。十二指肠生长抑素瘤很罕见,其诊断通常为偶然发现。手术是该病早期的合适治疗方法,治愈机会较大。