Periampullary Carcinoid Tumor in a Woman with Neurofibromatosis
| Autor: | Lauren Buck, Melanie L. Richards, W. Brian Perry |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
Oncology Ampulla of Vater medicine.medical_specialty Lower gastrointestinal bleeding Neurofibromatoses Gastrointestinal Stromal Tumors Common Bile Duct Neoplasms Antineoplastic Agents Carcinoid Tumor Comorbidity Hematocrit Gastroenterology Piperazines Neoplasms Multiple Primary Internal medicine Humans Medicine Outpatient clinic Neurofibromatosis Stromal tumor Jejunal Neoplasms medicine.diagnostic_test GiST business.industry medicine.disease Pyrimidines Imatinib mesylate medicine.anatomical_structure Benzamides Imatinib Mesylate Female Surgery business |
| Zdroj: | Current Surgery. 63:252-254 |
| ISSN: | 0149-7944 |
| DOI: | 10.1016/j.cursur.2006.04.014 |
| Popis: | LINICAL PRESENTATION: A 37-year-old woman with ype 1 neurofibromatosis (NF1) presented to the outpatient clinic n July, 2005, with symptoms of fatigue and lightheadedness. She ad a history of intermittent lower gastrointestinal bleeding and ad been hospitalized 6 months previously with a hemoglobin of .5 g/dl and a hematocrit of 23.8%. Upper and lower endoscopic tudies did not identify a bleeding source and an upper gastroinestinal barium study with follow through was also negative. She emained stable after receiving a total of 2 units of packed red blood ells and was discharged after 4 days. Outpatient capsule endosopy showed several areas of submucosal thickening without an bvious source of bleeding identified. Her medical history was significant for a resection of a highrade gastrointestinal stromal tumor (GIST) of the jejunum in ovember 2002. The radial margin was positive for tumor, and he patient had been taking Gleevac (Imatinib mesylate) up to er recent hospitalization. She had recently self-discontinued his medication. At 4 months postoperatively, the patient had a ild elevation of her alkaline phosphatase to 230 IU/L and the emaining liver function tests were normal. A computed toography (CT) scan showed dilation of the common bile duct nd a 1.5 1.2 centimeter periampullary mass. An endoscopic etrograde pancreaticogram (ERCP) with a spincterotomy was erformed. A biopsy identified the mass as a carcinoid tumor Fig. 1). Her alkaline phosphatase level normalized. Given that he was at a high risk for recurrence of her GIST and that the arcinoid tumor would be slow growing, the decision was made o follow her closely and plan re-exploration if there was evience of recurrent GIST or progression of her carcinoid tumor. Her medical history was otherwise unremarkable, as was the eview of systems. Other operations included 1 cesarean section, a ilateral tubal ligation, and an incidental appendectomy. Physical xamination was unremarkable. She was found to have a hemogloin of 6.6 g/dl and a hematocrit of 21.8%. Chemistry, liver funcion tests, serum serotonin, pancreatic polypeptide, serum gastrin, nd a 24-hour urine 5-hydroxyindolacetic acid level were all within ormal limits. A CT scan in May 2005 showed a stable 1.5 1.2 entimeter mass in the periampullar region of the duodenum (Fig. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect