CASE REPORT: Metastatic Carcinoid Tumor Discovered by Capsule Endoscopy and Not Detected by Esophagogastroduodenoscopy

Autor: Daniel C. DeMarco, Stephen W. Coates
Rok vydání: 2004
Předmět:
Zdroj: Digestive Diseases and Sciences. 49:639-641
ISSN: 0163-2116
DOI: 10.1023/b:ddas.0000026311.62364.0b
Popis: Small bowel tumors are difficult to diagnose because of delayed presentation, nonspecific signs and symptoms, and lack of accurate diagnostic studies. The most common site for carcinoid tumors is the gastrointestinal tract (73.7%) (1). Within the gastrointestinal tract, most occur in the small intestine (28.7%), with the ileum being the most common site (15.4%) (1). Carcinoid tumors of the distal small bowel are aggressive and have usually metastasized by the time of diagnosis (2). Duodenal carcinoid tumors are uncommon and account for less than 5% of all carcinoids of the gastrointestinal tract in Western society, with the majority being located in the first portion of the duodenum (1, 2). For the most part, duodenal carcinoids are indolent, especially when less than 1 cm and localized to the submucosa (3). Features associated with metastatic risk are involvement of the muscularis propria, a size greater than 2 cm, and the presence of mitotic figures (3). Due to the rarity of small bowel tumors, no studies have been undertaken to determine the “gold standard” among various imaging techniques for diagnosis. However, it is felt that duodenal carcinoids will be identified more frequently with the increased use of upper endoscopy (2–4). The characteristic endoscopic finding of duodenal carcinoid tumors is a smooth, round elevation with an irregularly shaped erythematous depression or ulceration (5). Other diagnostic studies have significant limitations in their usefulness for localizing tumors in the small bowel. The routine small bowel follow-through is simple and non
Databáze: OpenAIRE
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