Periampullary Duodenal Carcinoid Tumor with Complicated Pancreatic Pseudocyst

Kim, Jung Chul; Lee, Ho Young; Koh, Yang Seok; Joo, Jai Kyun; Cho, Chol Kyoon; Kim, Hyun Jong

Abstract

Most patients with duodenal carcinoids are asymptomatic or suffer from nonspecific symptoms. But the tumors in the periampullary region may be associated with symptoms of obstruction related to the size of the lesion. Two serial internal dranage procedures (cystogastrostomy and cystojejunostomy) were performed in a 46-year-old man because of recurred pancreatic pseudocyst at an interval of five months. Eight months after the first operation, an abdominal CT showed a remained pancreatic pseudocyst. And duodenoscopic findings showed a luminally protrusing mass, with preserved mucosa at the second portion of duodenum. Local resection of the mass was perfomed. Grossly, the mass had a 2 cm-sized, well circumscribed yellowish appearance. Microscopic findings showed well-defined intramucosal mass having almost glandular and nest of tumor cells showing uniform round nuclei, glandular and basophilic cytoplasm. And the nonspecific neuroendocrine markers chromogranin and NSE are positive. We report a case of Periampullary duodenal carcinoid tumor with complicated pancreatic pseudocyst.