title: Multiple carcinoids in the duodenum, pancreas and stomach accompanied with type A gastritis: a case report.
abstract: We report a case of multiple duodenal, pancreatic, and gastric carcinoids. A 67-year old woman was admitted to our hospital for treatment of a duodenal carcinoid. Laboratory tests revealed that the patient was associated with macrocytic anemia and hypergastrinemia, and type A gastritis was shown by gastrofiberscopy. During surgery, another tumor was incidentally found in the head of the pancreas. The tumors in the duodenum and pancreas were completely excised by pancreatoduodenectomy and immunohistologically diagnosed as gastrin-and serotonin-producing carcinoids, respectively. Pathological examination revealed that in addition to the grossly found carcinoids, there were subclinical carcinoids, one of which was an endocrine cell micronest, located in the stomach and duodenum. The tumors in the duodenum, pancreas, and stomach showed different characteristics from one another morphologically and immunochemically. Although no definitive evidence has been obtained, some sort of genetic anomaly may have been involved in this case, and hypergastrinemia due to duodenal gastrinoma may induce multiple gastric carcinoids.
authors.affiliation: Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences.1-757 Asahimachi-dori, Niigata City 951-8510, Japan. banbantak@msn.com
authors.forename: Takeo
authors.initials: T
authors.lastname: Bamba
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kosugi
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kanda
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Tsubono
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sakai
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Musha
authors.forename: Noriko
authors.initials: N
authors.lastname: Ishihara
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Hatakeyama
mesh_terms: D000368:Aged; D000748:Anemia, Macrocytic; D002276:Carcinoid Tumor / Q000150:complications / Q000473:pathology* / Q000601:surgery; D004379:Duodenal Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D005260:Female; D005756:Gastritis / Q000150:complications* / Q000473:pathology; D006801:Humans; D009378:Neoplasms, Multiple Primary / Q000150:complications / Q000473:pathology* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery