Rare disease
CASE REPORT
Duodenal carcinoid with carcinoid syndrome Ravikiran Naalla, Kamesh Konchada, Odaiyappan Kannappan, Ramachandra Lingadakai Department of General Surgery, Kasturba Hospital, Manipal University, Manipal, Karnataka, India Correspondence to Dr Ravikiran Naalla, [email protected]
SUMMARY Carcinoid tumours are uncommon well-differentiated neuroendocrine tumours. Primary duodenal carcinoids account for less than 2% of all gastrointestinal carcinoids. Duodenal carcinoids are seldom associated with carcinoid syndrome. We report a rare case of duodenal carcinoid presenting as a carcinoid syndrome in a middle-aged man with upper abdominal pain, hot flushes, diarrhoea and dry cough. Endoscopy-guided biopsy and 24 h urine 5-hydroxyindoleacetic acid (5-HIAA) proved the diagnosis. He was further evaluated and managed with definitive surgical treatment.
multiple nodules in the first and second parts of the duodenum (figure 1). Contrast-enhanced CT (CECT) of the abdomen showed homogeneously enhancing long segment wall thickening of the first, second, third and fourth parts of the duodenum (figure 2) and there were no hepatic metastases. The chest X-ray and two-dimensional echocardiogram were normal. Endoscopic biopsy revealed duodenal carcinoid and was positive for chromogranin A.
BACKGROUND
TREATMENT
Carcinoid tumours are rare and belong to the amine precursor uptake and decarboxylation system of tumours. They represent
CASE REPORT
Duodenal carcinoid with carcinoid syndrome Ravikiran Naalla, Kamesh Konchada, Odaiyappan Kannappan, Ramachandra Lingadakai Department of General Surgery, Kasturba Hospital, Manipal University, Manipal, Karnataka, India Correspondence to Dr Ravikiran Naalla, [email protected]
SUMMARY Carcinoid tumours are uncommon well-differentiated neuroendocrine tumours. Primary duodenal carcinoids account for less than 2% of all gastrointestinal carcinoids. Duodenal carcinoids are seldom associated with carcinoid syndrome. We report a rare case of duodenal carcinoid presenting as a carcinoid syndrome in a middle-aged man with upper abdominal pain, hot flushes, diarrhoea and dry cough. Endoscopy-guided biopsy and 24 h urine 5-hydroxyindoleacetic acid (5-HIAA) proved the diagnosis. He was further evaluated and managed with definitive surgical treatment.
multiple nodules in the first and second parts of the duodenum (figure 1). Contrast-enhanced CT (CECT) of the abdomen showed homogeneously enhancing long segment wall thickening of the first, second, third and fourth parts of the duodenum (figure 2) and there were no hepatic metastases. The chest X-ray and two-dimensional echocardiogram were normal. Endoscopic biopsy revealed duodenal carcinoid and was positive for chromogranin A.
BACKGROUND
TREATMENT
Carcinoid tumours are rare and belong to the amine precursor uptake and decarboxylation system of tumours. They represent
