Case Report
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 21, 2007; 13(15): 2247-2249
Published online Apr 21, 2007. doi: 10.3748/wjg.v13.i15.2247
Multiple carcinoids in the duodenum, pancreas and stomach accompanied with type A gastritis: A case report
Takeo Bamba, Shin-ichi Kosugi, Tatsuo Kanda, Toshihiro Tsubono, Yasuo Sakai, Nobuyuki Musha, Noriko Ishihara, Katsuyoshi Hatakeyama
Takeo Bamba, Shin-ichi Kosugi, Tatsuo Kanda, Katsuyoshi Hatakeyama, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Japan
Toshihiro Tsubono, Yasuo Sakai, Nobuyuki Musha, Division of Surgery, Saiseikai Niigata Daini Hospital, Japan
Noriko Ishihara, Division of Pathology, Saiseikai Niigata Daini Hospital, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Takeo Bamba, 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
Telephone: +81-25-2272228
Received: January 14, 2007
Revised: February 20, 2006
Accepted: February 14, 2007
Published online: April 21, 2007
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.

Keywords: Carcinoid, Stomach, Duodenum, Pancreas, Type A gastritis