ABSTRACT

Carcinoid tumors are rare neoplasms. Duodenal carcinoids are 3.4-11.9% of duodenal tumors. They are usually diagnosed incidentally. Herein we present a patient with duodenal carcinoid who was diagnosed incidentally. A 70 year old women was admitted to our clinic with complaints of abdominal pain, dyspepsia and constipation. While she was evaluated for etiology, a 4x2.5 cm nodular lesion in right surrenal gland was detected. There was no clinical suspicion of functional lesion, so a six month CT follow-up was suggested. Medical treatment did not relief the symptoms so an upper GIS endoscopy was planned. A 0.8 cm sessile polyp on anterior part of duodenum was detected at endoscopy. A biopsy was taken from the lesion. Biopsy report revealed a well-differentiated, NSE and Chromogranin-A positive neuroendocrine tumor (NET). Because the tumor was sessile and unsuitable for endoscopic resection, surgery was performed. Tumor was excised completely by gastrotomy. Patient was discharged at seventh postoperative day.

Carcinoid tumors are a part of NETs. NETs which are derived apart from pancreas and C-cell of thyroid are called carcinoids. Two thirds of carcinoid tumors originate from GI tract. Duodenal carcinoids are 3.4-11.9% of all duodenal tumors and 0.7-1.8% of primary intestinal tumors. They are usually diagnosed incidentally. Incidence during autopsies is 2-5 times higher than clinical incidence. Cytologic and histologic examination doesn’t tell much about level of malignancy. Distant metastases show high-grade malignant behaviour.