Gangliocytic paraganglioma of the duodenum is an extremely rare disease. Few cases have been reported in the literature from 1957 to 2010. We reported a 67-year-old man with gangliocytic paraganglioma of the duodenum.
Aged ; Duodenal Neoplasms ; diagnosis ; Duodenum ; pathology ; Humans ; Male ; Paraganglioma ; diagnosis

Ectopic pancreas is no longer a rare clinical condition, but its unusual clinical manifestations, locations or complications are of clinical interest. We experienced a case (a 48 year-old male patient) of duodenal ectopic pancreas complicated by chronic pancreatitis and pseudocyst formation of which preoperative imaging findings mimicked a large duodenal submucosal tumor with cystic degeneration such as a leiomyosarcoma. Simultaneous chronic pancreatitis was also demonstrated in the isotopic pancreas of the patient postoperatively. Herein we report a rare clinical condition occurring in an ectopic pancreas with a brief review of the literature.
Case Report ; Choristoma/complications/*diagnosis ; Chronic Disease ; Diagnosis, Differential ; Duodenal Diseases/complications/*diagnosis ; Duodenal Neoplasms/diagnosis ; Human ; Male ; Middle Age ; *Pancreas ; Pancreatic Pseudocyst/complications/*diagnosis ; Pancreatitis/complications/*diagnosis

Duodenal gangliocytic paraganglioma derived from neural crest is a peculiar neuroendocrine tumor. It is incidentally found during radiographic studies or due to gastrointestinal hemorrhage caused by frequent ulceration of the overlying mucosa. Most lesions are pedunculated and submucosal with distinctive histology consisting of endocrine cells, ganglion cells and spindle-shaped Schwann cells. We experienced a duodenal gangliocytic paraganglioma in a 40-year-old woman presenting with episodes of melena. Esophagogastroduodenoscopy revealed a submucosal ulcerated tumor in the second portion of duodenum and a biopsy confirmed gangliocytic paraganglioma. The tumor was enucleated through a duodenotomy. It's size was 5.5 X 3 X 1.5 cm sized and revealed positive cellular reaction for chromogranin, synaptophysin, neuron-specific enolase, and neurofilament by immunohistochemistry. The majority of the reported duodenal gangliocytic paraganglioma were of benign nature. Therefore, radical surgery or a lymph node dissection could be avoided if that disease was confirmed. However, thorough investigation for lymph node metastasis and postoperative follow-up are needed. We report the first case of a duodenal gangliocytic paraganglioma in Korea with a review of literature.
Adult ; Duodenal Neoplasms/*diagnosis/pathology/surgery ; English Abstract ; Female ; Humans ; Paraganglioma/*diagnosis/pathology/surgery

Somatostatinomas are rare functioning carcinoid tumors that usually arise in the pancreas and duodenum. They are seldom associated with typical clinical symptoms; their diagnosis is confirmed only by histological and immunohistochemical studies and the presence of specific hormones. Two distinct clinicopathological forms of somatostatinoma exist: duodenal and pancreatic somatostatinomas. Clinically, compared to pancreatic somatostatinomas, duodenal somatostatinomas are more often associated with nonspecific symptoms and neurofibromatosis, but less often with somatostatinoma syndrome or metastasis. Histologically, duodenal somatostatinomas frequently have psammoma bodies in the tumor cells. We report a case of duodenal somatostatinoma in 58-year-old man with vague epigastric pain and nausea. He did not have diabetes, steatorrhea, or cholelithiasis. Abdominal computed tomography showed a 25-mm mass in the duodenum and 25-mm nodule in the liver. Endoscopic retrograde cholangiopancreatography showed a duodenal submucosal tumor. Although the endoscopic biopsies were free of malignancy, the patient subsequently underwent Whipple's operation for the duodenal mass. Examination revealed as a somatostatinoma using a special stain for somatostatin.
Cholangiopancreatography, Endoscopic Retrograde ; Duodenal Neoplasms/diagnosis/*pathology/surgery ; Humans ; Male ; Middle Aged ; Somatostatinoma/diagnosis/*pathology/surgery

No abstract available.
Adult ; Carcinoid Tumor/*diagnosis/pathology ; Chromogranins/metabolism ; Duodenal Neoplasms/*diagnosis/pathology ; Duodenoscopy ; Humans ; Male

Carcinoma, Renal Cell ; complications ; Duodenal Neoplasms ; diagnosis ; secondary ; Humans ; Kidney Neoplasms ; complications ; Male ; Middle Aged

Duodenal choriocarcinoma, either primary or metastatic, is very rare. Early diagnosis and prompt initiation of chemotherapy improve the prognosis of this neoplasm. We herein present, together with the referred literatures, a case of a 47-year-old female patient who visited to our hospital with upper intestinal bleeding. She was diagnosed as duodenal choriocarcinoma by operation. Brain metastasis was found soon after the operation and combination chemotherapy was done.
Brain Neoplasms/*secondary ; Choriocarcinoma/*diagnosis/secondary ; Duodenal Neoplasms/*diagnosis/pathology ; Female ; Gastrointestinal Hemorrhage/*diagnosis ; Humans ; Middle Aged

The findings of upper gastrointestinal series(UGI), computed tomography (CT), and sonography(US) of ten duodenal adenocarcinoma confirmed by surgery (n=7) and endoscopic biopsy (n=3) were retrospectively analyzed. We performed US in all cases, CT and UGI in 8 out of 10 cases. UGI showed 4 cases of ulcerating type, 3 of stenotic type, and one failed to visualize duodenum due to previous gastrojejunostomy. UGI was more accurate in depicting the mucosal changes such as ulcer, however, it played a limited role in the evaluation of extraluminal extension. US showed 4 cases of hypocchoic wall thickening, 3 of hypoechoic extraluminal mass, and one of polypoid intraluminal mass but 2 were not detected on US. US accurately detected hepatic and pancreatic metastasis, however, it played a limited role in the evaluation of direct colonic invasion. CT showed was eccentric wall thickening in 4 cases, large extraluminal mass in 2, and low density intraluminal mass in but one was missed on CT. CT was the most accurate modality to determine the extent of the lesion and adjacent or distant metastasis but it could be misdiagnosed as submucosal tumor if the extraluminal component is large. UGI, CT and US can be used complementary for accurate diagnosis of a duodenal cancer. US may be used as a screening tool for detecting duodenal cancer.
Adenocarcinoma* ; Biopsy ; Colon ; Diagnosis ; Duodenal Neoplasms ; Duodenum* ; Gastric Bypass ; Mass Screening ; Neoplasm Metastasis ; Retrospective Studies ; Ulcer

OBJECTIVETo investigate the early diagnosis of primary duodenal carcinoma and its outcome after surgical procedure.

METHODSTwenty-two patients with primary duodenal carcinoma treated operatively between 1983 and 1997 were analyzed retrospectively. Eleven patients complained of epigastric pain and discomfort, 5 jaundice, 4 nausea and vomiting and 2 epigastric fullness. The correct diagnosis rate for endoscopy was 90.0% (9/10), for duodenography 86.7% (13/15), for ultrasound examination 33.3% (4/12) and for computerized tomography (CT) scanning 58.3% (7/12), respectively. All of the 22 patients received surgery including pancreaticoduodenectomy (12 patients), segmental resection (4) and bypass operation (gastrojejunostomy and cholecystojejunostomy or cholangiojejunostomy) (6).

RESULTSPrimary duodenal carcinoma was characterized nonspecifically, and the correct diagnosis was based on endoscopy and duodenography. The follow-up rate of this group was 86.4% (19/22). The 1-, 3-, 5-year survival rates of patients receiving radical resection (n = 16, 1 patient lost follow-up) were 86.7% (13/15), 46.7% (7/15), and 26.7% (4/15), respectively. The 5-year survival rate of patients receiving pancreaticoduodenectomy was 27.3% (3/11), and the 5-year survival rate of patients having segmental resection was 1/4. No patient (n = 6, 2 lost follow-up) with primary duodenal carcinoma treated by bypass procedure survived more than one year. There was a significant difference between patients receiving radical procedure and bypass operation (chi(2) = 6.84, P < 0.01).

CONCLUSIONRadical resection might improve the survival of patients with primary duodenal carcinoma.

Adult ; Aged ; Duodenal Neoplasms ; diagnosis ; mortality ; surgery ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Survival Rate

The occurrence of double primary cancer of the esophagus and duodenum is considered to be very rare. Moreover, it is difficult to manage this type of double cancer because esophageal cancer has a biologic tendency towards early metastasis. Yet the development of endoscopy such as endoscopic ultrasonography (EUS), the new diagnostic imaging modalities such as PET/CT and advanced pathologic interpretation can lead to an early diagnosis of these multiple primary neoplasms. Appropriate intervention with various therapeutic tools then becomes possible, so these multiple primary neoplasms are not currently obstinate problems. We experienced one patient with double primary cancer; we simultaneously found esophageal cancer and duodenal cancer via endoscopy, and we wanted to treat them with chemo- radiation therapy and endoscopic submucosal dissection, but we failed to persuade the patient to accept the treatment.
Diagnostic Imaging ; Duodenal Neoplasms ; Duodenum ; Early Diagnosis ; Endoscopy ; Endosonography ; Esophageal Neoplasms ; Hematemesis ; Humans ; Neoplasm Metastasis ; Neoplasms, Multiple Primary