Endoscopy 2004; 36(7): 651-655
DOI: 10.1055/s-2004-814539
Review
© Georg Thieme Verlag Stuttgart · New York

Local Endoscopic Removal of Duodenal Carcinoid Tumors

J.  Dalenbäck1 , G.  Havel2
  • 1Dept. of Surgery, Frölunda Specialist Hospital, University of Gothenburg, Sweden
  • 2Dept. of Pathology, Capio Diagnostik Ltd., Central Hospital, Skövde, Sweden
Further Information

Publication History

Submitted 16 May 2003

Accepted after Revision 20 February 2004

Publication Date:
09 July 2004 (online)

A swift and aggressive diagnostic and therapeutic approach is advisable when managing submucosal or polypoid lesions in the duodenum, since it is not possible to distinguish small, benign, and unremarkable duodenal growths macroscopically from malignant tumors such as carcinoids. This paper presents a systematic review of the published literature listed in Medline, focusing on the results after endoscopic treatment of duodenal carcinoids during the last 15 years; on the biological behavior of duodenal carcinoids; and on the endoscopic appearance of duodenal carcinoids. Endoscopic ultrasonography (EUS) is extremely useful in the diagnostic and preoperative work-up. The results indicate that endoscopic removal of duodenal carcinoids smaller than 1 cm that are located outside the periampullary region, with no EUS signs of invasion of the muscularis propria, is a safe, patient-friendly, adequate, and effective treatment.

References

  • 1 Burke A P, Federspiel B H, Sobin L H. et al . Carcinoids of the duodenum: a histologic and immunohistochemical study of 65 tumors.  Am J Surg Pathol. 1989;  13 828-837
  • 2 Burke A P, Sobin L H, Federspiel B H. et al . Carcinoid tumors of the duodenum: a clinicopathologic study of 99 cases.  Arch Pathol Lab Med. 1990;  114 700-704
  • 3 Makhlouf H R, Burke A P, Sobin L H. Carcinoid tumors of the ampulla of Vater: a comparison with duodenal carcinoid tumors.  Cancer. 1999;  85 1241-1249
  • 4 Bornstein-Quevedo L, Gamboa-Dominguez A. Carcinoid tumors of the duodenum and ampulla of Vater: a clinicomorphologic, immunohistochemical, and cell kinetic comparison.  Hum Pathol. 2001;  32 1252-1256
  • 5 Soga J. Endocrinocarcinomas (carcinoids and their variants) of the duodenum: an evaluation of 927 cases.  J Exp Clin Cancer Res. 2003;  22 349-363
  • 6 Kirshbom P M, Kherani A R, Onaitis M W. et al . Foregut carcinoids: a clinical and biochemical analysis.  Surgery. 1999;  126 1105-1110
  • 7 Zyromski N J, Kendrick M L, Nagorney D M. et al . Duodenal carcinoid tumors: how aggressive should we be?.  J Gastrointest Surg. 2001;  5 588-593
  • 8 Thomas R M, Sobin L H. Gastrointestinal cancer.  Cancer. 1995;  75 (Suppl 1) 154-170
  • 9 Kloppel G, Heitz P U, Capella C, Solcia E. Pathology and nomenclature of human gastrointestinal neuroendocrine (carcinoid) tumors and related lesions.  World J Surg. 1996;  20 132-141
  • 10 Hauser H, Wolf G, Uranus S, Klimpfinger M. Neuroendocrine tumours in various organ systems in a ten-year period.  Eur J Surg Oncol. 1995;  21 297-300
  • 11 Soga J. Carcinoid tumors: an analysis of Japanese series.  J Exp Clin Cancer Res. 1985;  4 233-244
  • 12 Yamamoto C, Aoyagi K, Suekane H. et al . Carcinoid tumors of the duodenum: report of three cases treated by endoscopic resection.  Endoscopy. 1997;  29 218-221
  • 13 Nishimori I, Morita M, Sano S. et al . Endosonography-guided endoscopic resection of duodenal carcinoid tumor.  Endoscopy. 1997;  29 214-217
  • 14 Yoshikane H, Goto H, Niwa Y. et al . Endoscopic resection of small duodenal carcinoid tumors with strip biopsy technique.  Gastrointest Endosc. 1998;  47 466-470
  • 15 Burke A P, Sobin L H, Shekitka K M. et al . Somatostatin-producing duodenal carcinoids in patients with von Recklinghausen’s neurofibromatosis: a predilection for black patients.  Cancer. 1990;  65 1591-1595
  • 16 Thompson G B, van Heerden J A, Martin J K Jr. et al . Carcinoid tumors of the gastrointestinal tract: presentation, management, and prognosis.  Surgery. 1985;  98 1054-1063
  • 17 Marshall J B, Bodnarchuk G. Carcinoid tumors of the gut: our experience over three decades and review of the literature.  J Clin Gastroenterol. 1993;  16 123-129
  • 18 Hirakawa K, Iida M, Matsui T. et al . Endoscopic findings in carcinoid tumor of the duodenum.  Am J Gastroenterol. 1991;  86 603-605
  • 19 Yoshikane H, Tsukamoto Y, Niwa Y. et al . Carcinoid tumors of the gastrointestinal tract: evaluation with endoscopic ultrasonography.  Gastrointest Endosc. 1993;  39 375-383
  • 20 Yoshikane H, Suzuki T, Yoshioka N. et al . Duodenal carcinoid tumor: endosonographic imaging and endoscopic resection.  Am J Gastroenterol. 1995;  90 642-644
  • 21 Acs G, McGrath C M, Gupta P K. Duodenal carcinoid tumor: report of a case diagnosed by endoscopic ultrasound-guided fine-needle aspiration biopsy with immunocytochemical correlation.  Diagn Cytopathol. 2000;  23 183-186
  • 22 Perng C L, Lin H J, Wang K. et al . Treatment of duodenal carcinoid by strip biopsy.  J Clin Gastroenterol. 1995;  20 168-171
  • 23 Albizzatti V, Casco C, Gastaminza M. et al . Endoscopic resection of two duodenal carcinoid tumors.  Endoscopy. 2000;  32 S42
  • 24 Bowers S P, Smith C D. Laparoscopic resection of posterior duodenal bulb carcinoid tumor.  Am Surg. 2003;  69 792-795
  • 25 Blanc P, Porcheron J, Pages A. et al . [Laparoscopic excision of a duodenal neuroendocrine tumor; in French].  Ann Chir. 2000;  125 176-178
  • 26 Toyonaga T, Nakamura K, Araki Y. et al . Laparoscopic treatment of duodenal carcinoid tumor: wedge resection of the duodenal bulb under endoscopic control.  Surg Endosc. 1998;  12 1085-1087

J. Dalenbäck, M. D., Ph. D.

Dept. of Surgery, Frölunda Specialist Hospital, Box 133

S-42122 Västra Frölunda/Gothenburg · Sweden

Fax: +46-31-3425079

Email: jan.dalenback@vgregion.se