A Case of Duodenal Adenocarcinoid with Liver Metastasis

Yoshiko Yano, Wataru Takayama, Makoto Sugaya, Shinsuke Kakuta, Tetsumori Kou, Arata Furuki* and Susumu Kobayashi

Department of Surgery and Department of Pathology*, Chiba Prefecture Hospital of Sawara

A 60-year-old woman referred for abnormal duodenal findings in a mass screening X-ray examination was found in upper gastrointestinal endoscopy to have an ulcer at the duodenal bulb. Biopsy was negative for malignancy and the patient was treated with antacids. Ultrasonography and computed tomography at the outpatient clinic showed multiple masses at hepatic segments 4, 5, and 8. Ultrasound-guided needle biopsy of the liver mass showed adenocarcinoma. The patient was admitted and underwent left hepatic lobectomy. Because the duodenal ulcer remained unchanged despite drug administration, partial duodenectomy and gastrectomy with lymph node dissection were conducted on suspicion of malignancy. Pathological findings showed that the duodenal and liver tumors shared glandular and neuroendocrine differentiation. Immunohistochemical staining of liver and duodenal tumors was positive for synaptophisin and chromogranin A. The definitive diagnosis was adenocarcinoid of the duodenum with liver metastasis. The patient has been free from disease recurrence in the 18 months since surgery. Adenocarcinoid of the duodenum is very rare and this is, to our knowledge, the first report of surgery to treat duodenal adenocarcinoid with liver metastasis.

Key words
adenocarcinoid, duodenum, liver metastasis

Reprint requests
Yoshiko Yano Department of Surgery, Chiba Prefecture Hospital of Sawara
2285 Sawara, Katori, 287-0003 JAPAN

Accepted
October 29, 2007

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