A Case of Carcinoid of Accessory Papilla of the Duodenum

Ryo Tamura, Ryo Hosotani, Mariko Takada¹⁾, Akira Miki, Kenji Uryuhara, Hiroyuki Kobayashi, Noriyuki Okada, Satoshi Kaihara and Yukihiro Imai²⁾

Department of Surgery, Department of Gastroenterology¹⁾ and Department of Pathology²⁾, Kobe City Medical Center General Hospital

We report a case of accessory papilla carcinoid of the duodenum. A 70-years-old man admitted for a submucosal tumor of the accessory papilla found in routine gastrointestinal fiber examination. Preoperative hypotonic duodenography, endoscopic retrograde cholangiopancreatography (ERCP), and tumor biopsy to have a localized carcinoid tumor in the mucosal and submucosal layer of the accessory papilla. The tumor was 14 mm in diameter. We conducted subtotal stomach-preserving pancreatoduodenectomy. No lymph node or distant metastasis was detected in preoperative imaging, but one regional lymph node metastasis was detected postoperatively. Carcinoid tumor of the duodenal accessory papilla is very rare, with only 17 cases reported. Carcinoid tumor size and depth are generally recognized as important in treatment because these factors are closely correlated with the frequency of lymph node and distant metastasis. Carcinoid tumor of the accessory papilla has been reported to metastasize far more frequently than those arising from other organs, so we recommend pancreatoduodenectomy with regional lymph node dissection, even if tumor size and depth are small and shallow.

Key words
carcinoid tumor, duodenum, accessory papilla

Reprint requests
Ryo Tamura Department of Pediatric Surgery, Kobe Children's Hospital
1-1-1 Takakuradai, Suma-Ku, Kobe, 654-0081 JAPAN

Accepted
September 16, 2009

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