A Case of the Small Duodenal Carcinoid that the Site of the Primary Lesion Became Clear from the Isolated Lymph Node Metastasis After Hepatectomy of Liver Metastases

Sadanobu Izumi and Kunihiko Shiota

Department of Surgery, Kagawa Prefectural Central Hospital

A 61-year-old woman was treated by partial hepatectomy to multiple hepatic tumors in January 2006. After the operation, it was diagnosed as carcinoid. Therefore we searched a whole body by blood analysis, CT, GIF and CF, but no abnormal findings were revealed. In June 2006, PET/CT to detect the primary site revealed a positive accumulation at the inferior pole of the left kidney level and the left side of the aorta. So we diagnosed a lymph node metastasis or an intestinal tumor, and performed laparotomy. Intra abdominal findings revealed a duodenal tumor 1 cm in diameter of the 3 rd portion near the lymph node metastasis 2 cm in diameter detected by PET/CT. After distal duodenectomy, microscopic findings showed a duodenal carcinoid and lymph node metastases. And findings of liver carcinoid were likewise; so final diagnosis was metastatic liver carcinoid. This time we experienced an interesting case that the site of the primary lesion became clear with discovery of the isolated lymph node metastasis after hepatectomy of liver metastases, so reported.

Key words
duodenum, liver carcinoid, PET

Reprint requests
Sadanobu Izumi Department of Surgery, Kagawa Prefectural Central Hospital
5-4-16 Bancho, Takamatsu, 760-8557 JAPAN

Accepted
May 30, 2007

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