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carcinoid tumor of the duodenum and accessory papilla associated with polycythemia vera

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World Journal of Gastroenterology 2005年第24期11卷 3794-3796页

作者： Horng-Yuan Wang Ming-Jen Chen Tsen-Long Yang Ming-Chih Chang Yu-Jan Chan Division of Gastroenterology Department of Surgery Division of Hematology Department of Pathology

carcinoid tumors have been reported in a wide range of organs but most frequently involve the gastrointestinal tract; however, duodenal carcinoid tumors are rare. We report a 50-year-old male patient complaining of multiple melenas for 3 wk. The panendoscopy and endoscopic retrograde cholangiopancreaticography revealed swelling accessory papilla with an ulcer. The biopsy taken showed a carcinoid tumor. The lesion was removed by wide resection. Patient was found to have an abnormal blood cell count during the follow-up period with elevated levels of hemoglobin and hematocrit of 21.2 g/dL and 63.5%,respectively, thrombocytosis of 501 000/μL, and leukocytosis of 20 410/μL. He was diagnosed as a polycythemia vera by a hematologist after further evaluation. He received periodic phlebotomy and hydroxyurea treatment. The response was good and his hematocrit was stabilized by periodic phlebotomy in the range of 44-49% during the last 2 years. The possible origin of UGI bleeding by a duodenal carcinoid tumor, although rare, should be considered. There has been one case report of a duodenal carcinoid tumor that involved accessory papilla of the pancreas divisum and one case report of metastatic carcinoid tumor associated with polycythemia vera. It is different in our patient as compared with the latter report, which mentioned a polycythemia vera patient who was found to have a metastatic carcinoid in the 17 years follow-up period. Chemotherapy had been given before the carcinoid tumor was revealed. Our patient had no previous chemotherapy for polycythemia vera before he was found to have duodenal carcinoid tumor; this excludes the possibility of chemotherapy induced carcinoid tumor, although it had been suspected in the previous report. In our patient, the existence of both diseases may be by predisposition of each other since both diseases have an increased incidence of other neoplasm, or they may be coexistent incidentally.

关键词： carcinoid tumor Accessory papilla Polycythemia vera

Gastric carcinoid tumor in a patient with a past history of gastrointestinal stromal tumor of the stomach

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World Journal of Gastroenterology 2008年第44期14卷 6884-6887页

作者： Chien-Yuan Hung Ming-Jen Chen Shou-Chuan Shih Tsang-Pai Liu Yu-Jan Chan Tsang-En Wang Wen-Hsiung Chang Division of Gastroenterology Department of Internal MedicineMackay Memorial Hospital and Mackay MedicineNursing and Management CollegeTaipeiTaiwanChina Department of General Surgery Mackay Memorial HospitalTaipeiTaiwanChina Department of Pathology Mackay Memorial HospitalTaipeiTaiwanChina

Gastrointestinal stromal tumor is the most common mesenchymal tumor in the gastrointestinal tract. It may coexist with other type of cancers,and if so,the tumors usually involve the stomach. The most common associated cancers are gastrointestinal carcinomas. We report a 65-year-old woman with a history of gastric gastrointestinal stromal tumor who had undergone subtotal segmental gastrectomy. New polypoid lesions were detected on a follow-up gastroscopy one year later. The lesions were biopsied and found to be carcinoid tumors. There was serum hypergastrinemia,and type 1 gastric carcinoid tumor was diagnosed. A total gastrectomy was performed. Pathologic examination revealed both carcinoid tumors and a recurrent gastrointestinal stromal tumor.

关键词： Hypergastrinemia Multiple primaryneoplasms Stomach Gastrointestinal stromal tumor carcinoid tumor

Malignant carcinoid tumor of the cystic duct:a rare cause of bile duct obstruction

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Hepatobiliary & Pancreatic Diseases International 2009年第6期8卷 640-646页

作者： Evangelos Felekouras Athanasios Petrou Konstantinos Bramis Evangelos Prassas Ioannis Papaconstantinou Nikoleta Dimitriou Anastasia Pazaiti Christos Tsigris Athanasios Giannopoulos First Department of Surgery National and Kapodistrian University of AthensMedical SchoolLAIKON General Hospital

BACKGROUND:carcinoid tumors of the extrahepatic biliary tree are extremely rare malignancies,accounting for 0.2%-2%of all gastrointestinal carcinoid tumors,while carcinoids of the cystic duct are an uncommon entity and an extremely unusual cause of bile duct ***:After an extensive literature review,we retrospectively analysed 61 cases of carcinoid tumor of the biliary tree as well as one additional case of a 60-yearold female with symptoms and laboratory/imaging examination findings compatible with those of a malignant biliary tract *** laparotomy,resection of the gallbladder and common bile duct was *** study revealed a well-differentiated neuroendocrine carcinoma of the cystic *** patient remained disease-free at 16 ***:Our presentation is the seventh case reported in the world *** to cholangiocarcinoma,analysis of the reviewed group indicates an increased incidence of extrahepatic carcinoid tumors in younger persons along with a slight female ***,the most common anatomic location is the common bile duct,followed by the perihilar region and the cystic *** is the most common *** surgery was realized in the majority of cases and longterm disease-free survival was achieved when surgery was ***:carcinoid tumors obstructing the biliary tree are extremely difficult to diagnose preoperatively,and nearly impossible to differentiate from non-neuroendocrine *** surgery offers the only potential cure for both biliary carcinoids and cholangiocarcinoma,we recommend aggressive surgical therapy as the treatment of choice in every case of potentially resectable biliary tumor.

关键词： carcinoid tumor biliary tree cystic duct well-differentiated endocrine tumor

Meckel Diverticulum carcinoid tumor Complicated by Ileal Invagination. About One Case at Vichy Hospital

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Case Reports in Clinical Medicine 2022年第4期11卷 133-137页

作者： Omar Sow Nicolas Sorbane Fetche Alice Anusca Lionel Perrot Service de Chirurgie Viscérale et Digestive Centre Hospitalier de Vichy Vichy France Service de Chirurgie H&ocirc pital de la Paix Université Assane Seck de Ziguinchor Ziguinchor Senegal

Meckel’s diverticulum is a common pathology in children and rare in adults. We present a case of a 79-year-old patient in which a significant gastrointestinal bleeding, whose paraclinical explorations confirmed a fatty tumor of the terminal ileum. The exploratory coelioscopy revealed a tumor of the Meckel diverticulum complicated of intestinal invagination, resected at the same time with resection and extracorporeal anastomosis by mini coelio-guided laparotomy. Histology confirmed the presence of heterotopical tissue of the duodenal mucosa with Brunner cells and a carcinoid tumor. In conclusion, this clinical case shows that coelioscopy can be considered a very important diagnostic and therapeutic tool in this pathology especially in the elderly.

关键词： Meckel’s Diverticulum carcinoid tumor Invagination Cœliosurgery

carcinoid tumors in the Middle Ear:a Case Report and Literature Review

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Journal of Otology 2006年第1期1卷 57-60页

作者： WANG Entong,1 GONG Weixi,1 DA Jiping21. Department of Otolaryngology, Head and Heck Surgery, 36 Fucheng Road, Beijing 100036, China 2. Department of Pathology, 36 Fucheng Road, Beijing 100036, China Department of Otolaryngology Head and Heck Surgery 36 Fucheng Road Beijing 100036 China Department of Pathology 36 Fucheng Road Beijing 100036 China

Middle ear carcinoid tumor (MEC T) is rare. Only 46 cases of MECT have been reported in the literature since the first case of MECT was described in 1980. We present here a case of primary MECT initially diagnosed as inflammatory aural polyp. The case was a 43-year-old women complaining of right ear chronic otorrhea and hearing loss over a period of five years, with a blockage sensation in the right ear for two years. Audiometry showed conductive hearing loss in the right ear. Physical examination and CT scans showed a mass in the right external auditory canal and middle ear, surrounding the ossicular chain. Pathologic study of surgically removed specimen revealed features of carcinoid tumor with positive staining to chromogranin A and synaptophysin in tumor cells. Local radiation of 60 Gy was applied. The patient has been followed up for more than one year. Postoperative histopathological examination showed no evidence of MECT recurrence one year after surgery, but inflammatory changes in the middle ear. Relevant literatures were reviewed. Clinical, histopathological, immunohistochemical and ultrastructural features of MECT, and strategies in MECT diagnosis and management are discussed.

关键词： carcinoid tumor middle ear diagnosis surgery

Clinicopathologic analysis of eight cases of pancreatic carcinoid tumors

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Chinese Medical Journal 2009年第13期122卷 1591-1594页

作者： HE Xiao-wen WU Xiao-jian HE Xiao-sheng ZOU Yi-feng KE Jia WANG Jian-ping LAN Ping Department of Colorectal Surgery the Sixth Affiliated Hospital Sun Yat-Sen University Guangzhou Guangdong 510655 China

carcinoids of the pancreas are exceedingly rare tumors that originate from the enterochromaffin cells of the gastroenteropancreatic neuroendocrine system. According to a recent report, pancreatic carcinoids are found in only 0.58% （79/13 715 cases） of the entire carcinoid group. To date, very limited information regarding the detection and diagnosis of this entity has been reported in the available literature. Although pancreatic carcinoid tumors grow slowly and show an indolent clinical behavior, they are potentially malignant. Due to the late onset of clinical symptoms and delayed diagnosis of the tumor, there was a high incidence of distant metastases that hampered long-term survival for many patients, leading to an unfavorable overall prognosis.

关键词： carcinoid tumor pancreas pathology metastasis

Angiogenic markers endoglin and vascular endothelial growth factor in gastroenteropancreatic neuroendocrine tumors

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World Journal of Gastroenterology 2011年第2期17卷 219-225页

作者： Patricia Kuiper Lukas JAC Hawinkels Eveline SM de Jonge-Muller Izk Biemond Cornelis BHW Lamers Hein W Verspaget Department of Gastroenterology and Hepatology Leiden University Medical Centre Department of Molecular Cell Biology and Centre for Biomedical Genetics Leiden University Medical Centre

AIM:To investigate the expression and potential prognostic role of vascular endothelial growth factor(VEGF) and endoglin in gastroenteropancreatic neuroendocrine tumors(GEP-NETs) . METHODS:Microvessel density(MVD) in GEP-NETs was evaluated using endoglin and CD31 *** addition,tissue levels of endoglin and VEGF were determined in homogenates by ELISA. RESULTS:Endoglin was highly expressed on tumor endothelial ***31 MVD in GEP-NETs was significantly higher compared to endoglin MVD(Ptumors compared to associated normal tissue. This increased endoglin tissue expression in tumors was significantly related to tumor size(Ptumor stage(P=0.02) ,whereas expression of VEGF was not. CONCLUSION:We suggest that endoglin is a potential marker to indicate and predict metastases,which might be useful in the post-resection therapeutic approach of patients with GEP-NETs.

关键词： Neuroendocrine tumor carcinoid tumor Angiogenesis factors Endoglin Vascular endothelial growth factor

Endoscopic resection of carcinoid of the minor duodenalpapilla

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World Journal of Gastroenterology 2007年第27期13卷 3763-3764页

作者： Takao Itoi Atsushi Sofuni Fumihide Itokawa Takayoshi Tsuchiya Toshio Kurihara Fuminori Moriyasu Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo Japan

We encountered a 65-year-old man with a carcinoid tumor of the minor duodenal papilla. Since he had liver cirrhosis and completely refused surgery, we performed an endoscopic snare papillectomy. The papillectomy was performed successfully without procedure-related complication. The specimens revealed a carcinoid tumor showing that the margin of the tumor was positive. One week later, upper GI endoscopy was performed and the biopsy specimens obtained from base of ulcer showed no neoplastic cells. We performed a duodenoscopy and CT 3, 6 and 18 mo later, and there was no macroscopic or microscopic evidence of tumor recurrence after more than 4 years.

关键词： Endoscopic papillectomy carcinoid tumor Minor duodenal papilla Papilla of Vater tumor Duodenal papilla

Recent trends in the treatment of well-differentiated endocrine carcinoma of the small bowel

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World Journal of Gastroenterology 2010年第14期16卷 1696-1706页

作者： Gilles Poncet Jean-Luc Faucheron Thomas Walter Department of Digestive Surgery Edouard Herriot Hospital 69437 Lyon cedex 03 France Department of Colorectal Surgery Michallon Hospital 38043 Grenoble cedex France Department of Medical Oncology Pavillon H Edouard Herriot Hospital 69437 Lyon Cedex 03 France

Well-differentiated endocrine carcinomas of the small bowel are fairly rare neoplasms that present many clinical challenges. They secrete peptides and neuroamines that may cause carcinoid syndrome. However, many are clinically silent until late presentation with major effects. Initial treatment aims to control carcinoid syndrome with somatostatin analogs. Even if there is metastatic spread, surgical resection of the primitive tumor should be discussed in cases of retractile mesenteritis, small bowel ischemia or subocclusive syndrome in order to avoid any acute complication, in particular at the beginning of somatostatin analog treatment. The choice of treatment depends on the symptoms, general health of the patient, tumor burden, degree of uptake of radionuclide, histological features of the tumor, and tumor growth. Management strategies include surgery for cure (which is rarely achieved) or for cytoreduction, radiological interventions (transarterial embolization or radiofrequency ablation), and chemotherapy (interferon and somatostatin analogs). New biological agent and radionuclide targeted therapies are under investigation. Diffuse and non-evolving lesions should also be simplymonitored. Finally, it has to be emphasized that it is of the utmost importance to enroll these patients with a rare disease in prospective clinical trials assessing new therapeutic strategies.

关键词： Gastrointestinal neoplasms Neuroendocrine carcinoma carcinoid tumor Somatostatin analogs Therapeutic chemoembolization Surgery