title: [A case of neuroendocrine carcinoma of the duodenal papilla].
abstract: A 75-year-old man with a complaint of right hypochondrial pain consulted our hospital, and was diagnosed as having acute cholecystitis. We performed percutaneous transhepatic gallbladder drainage (PTGBD), and the cholecystitis resolved. However, obstructive jaundice occurred 2 weeks later. Thus, we performed an in-depth investigation and detected duodenal papilla cancer (cT3N1M0, Stage III). Pancreatoduodenectomy was performed. As postoperative histological diagnosis yielded positive and strongly positive immunostaining for synaptophysin and Ki-67, respectively, we diagnosed the patient as having neuroendocrine carcinoma (NEC) of the duodenal papilla. Three months after surgery, computed tomography (CT) scan showed multiple liver metastases and lymph node metastasis. Chemotherapy with carboplatin and etoposide was administered, but severe neutropenia developed, and therefore, the chemotherapy was discontinued. Subsequently, we decided on a policy of best supportive care (BSC). The patient died 11 months after surgery. NEC of the duodenal papilla is reported to be a rare and rapidly progressing disease and is associated with a very poor prognosis. Herein, we report a case of a patient in whom NEC of the duodenal papilla was resected.
authors.affiliation: Dept. of Surgery, Yao Municipal Hospital.
authors.forename: Reishi
authors.initials: R
authors.lastname: Toshiyama
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Yokoyama
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Mitsunobu
authors.initials: M
authors.lastname: Takeda
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Tokuoka
authors.forename: Jin
authors.initials: J
authors.lastname: Matsuyama
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Ide
authors.forename: Takashi
authors.initials: T
authors.lastname: Morimoto
authors.forename: Yukio
authors.initials: Y
authors.lastname: Fukushima
authors.forename: Takashi
authors.initials: T
authors.lastname: Nomura
authors.forename: Ken
authors.initials: K
authors.lastname: Kodama
authors.forename: Ikue
authors.initials: I
authors.lastname: Shiba
authors.forename: Masashi
authors.initials: M
authors.lastname: Takeda
authors.forename: Yo
authors.initials: Y
authors.lastname: Sasaki
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D003131:Combined Modality Therapy; D004379:Duodenal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D017809:Fatal Outcome; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male