| Theme |
Advancement in Diagnosis and Treatment for Duodenal Neoplasms |
| Title |
Therapeutic Strategy for Duodenal Neuroendocrine Tumors |
| Author |
Yorimasa Yamamoto |
Division of Gastroenterological Internal Medicine, Cancer Institute Hospital |
| Author |
Junko Fujisaki |
Division of Gastroenterological Internal Medicine, Cancer Institute Hospital |
| Author |
Toshiaki Hirasawa |
Division of Gastroenterological Internal Medicine, Cancer Institute Hospital |
| Author |
Soya Nunobe |
Division of Gastroenterological Surgery, Cancer Institute Hospital |
| Author |
Naoki Hiki |
Division of Gastroenterological Surgery, Cancer Institute Hospital |
| Author |
Masahiro Igarashi |
Division of Gastroenterological Internal Medicine, Cancer Institute Hospital |
| [ Summary ] |
Carcinoids are a relatively rare type of tumor differentiated from neuroendocrine tumors (NET). These tumors were classified as grade being 1 (G1) in the WHO classification of 2010. In Japan, duodenal NET is more often observed in proximity to the rectum. The age of onset is most commonly in the 50s and more often observed in men. Many patients are diagnosed without symptoms. Endoscopic findings indicate tumors which are similar to submucosal tumors in nature. With increased tumor mass, a depressed segment is observed on the surface. Endoscopic ultrasonography is useful for the accurate measurement of tumor size. A definitive diagnosis of NET may confirm the positive findings observed with immunohistochemical staining with synaptophysin or chromogranin A in biopsy specimens. The principle treatment is surgical resection with lymph node dissection. If the tumor is 1 cm or less in size and is localized to the submucosa, endoscopic resection is one treatment option. However, even in these lesions, there may be those with lymph node metastasis. We must provide adequate preoperative informed consent to patients. |