title: Adenoendocrine carcinoma of the accessory papilla of the duodenum: report of a case.
abstract: This report describes a very rare case of an adenoendocrine carcinoma of the accessory papilla of the duodenum. A 70-year-old woman was admitted to the hospital complaining of epigastralgia. Gastrointestinal endoscopy showed a protruding tumor with ulceration at the accessory papilla of the duodenum. A biopsy revealed a small-cell carcinoma. Computed tomography showed a highly enhanced tumor in the early phase. No metastatic lesions were shown. Magnetic resonance cholangiopancreatography showed dilatation of the pancreatic duct, but a normal common bile duct. A pyloruspreserving pancreaticoduodenectomy was performed with lymph node dissection. Microscopically, the tumor was a small-cell neuroendocrine carcinoma with adenomatous differentiation. An immunohistochemical analysis showed positive staining for synaptophysin, chromogranin A, CD56, and carbohydrate antigen 19-9. The final diagnosis was an adenoendocrine carcinoma with lymph node metastasis. The postoperative course was uneventful and the patient is now doing well as an outpatient after 14 months of follow-up.
authors.affiliation: Organ Regenerative Surgery, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Atsushi
authors.initials: A
authors.lastname: Horiuchi
authors.forename: Motohira
authors.initials: M
authors.lastname: Yoshida
authors.forename: Shungo
authors.initials: S
authors.lastname: Yukumi
authors.forename: Koichi
authors.initials: K
authors.lastname: Sato
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sugishita
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishida
authors.forename: Maki
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Kayo
authors.initials: K
authors.lastname: Ishikawa
authors.forename: Kanji
authors.initials: K
authors.lastname: Kawachi
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000368:Aged; D018278:Carcinoma, Neuroendocrine / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D004379:Duodenal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D004702:Endocrine Glands / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D016577:Pancreaticoduodenectomy