Primary small-cell neuroendocrine carcinoma of the duodenum - a case report and review of literature.

Autor: Sata N; Department of Surgery, Jichi Medical School, 3311-1 Yakushiji Minami-kawachi Tochigi, Japan. sata@jichi.ac.jp, Tsukahara M, Koizumi M, Yoshizawa K, Kurihara K, Nagai H, Someya T, Saito K
Jazyk: angličtina
Zdroj: World journal of surgical oncology [World J Surg Oncol] 2004 Aug 15; Vol. 2, pp. 28. Date of Electronic Publication: 2004 Aug 15.
DOI: 10.1186/1477-7819-2-28
Abstrakt: Background: Small-cell neuroendocrine carcinoma in the duodenum is an extremely rare neoplasm with poor prognosis.
Case Presentation: A 57-year-old man presented with sudden onset gastrointestinal bleeding and fainting attacks. Duodenoscopy and hypotonic duodenography revealed a 3 x 3 cm protruding tumor with ulcerations situated opposite the ampulla of Vater in the second part of the duodenum. Local excision of the tumor was performed, followed by adjuvant chemotherapy with 5-fluoro uracil and leucovorin. Examination of the tumor by immunohistochemistry and electron microscopy indicated it to be neuroendocrine in nature, expressing synaptophysin and AE1/AE3, and containing dense core granules. The patient showed no sign of recurrence and has been disease-free for more than 48 months after surgery.
Conclusions: Most cases of small-cell neuroendocrine carcinoma in the duodenum show rapid progression of the disease, and even radical surgery with or without chemotherapy do not prevent death. We report a rare subtype of small-cell neuroendocrine carcinoma. This subtype appears to have a much better prognosis, and may be amenable to local excision, if the lesion is away from the ampulla of Vater.
Databáze: MEDLINE
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