A Case of Neuroendocrine Tumor of the Minor Duodenal Papilla
Open Access
- 1 January 2018
- journal article
- Published by Japan Surgical Association in Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
- Vol. 79 (4) , 899-907
Abstract
症例は74歳の男性．貧血精査で近医を受診，上部消化管内視鏡検査では主乳頭よりやや口側の十二指腸下行脚左壁に可動性良好な15mm大の腫瘍を，超音波内視鏡では第3層主体の均一な低エコー腫瘤を認め，生検結果から副乳頭原発の神経内分泌腫瘍（NET）G1と診断された．造影CTでは動脈早期相から濃染される13mm大の腫瘤と膵内胆管背側および膵鉤状突起左側辺縁に計4個の造影効果を示す最大径5mmの結節影を認めた．その他遠隔転移を示唆する所見はなく，亜全胃温存膵頭十二指腸切除術を施行した．病理組織学的検査では腫瘍は副乳頭に限局し，Ki-67指数1.7％，核分裂像（4/10 HPF）からNET G2と診断され，術前CTで認めた膵鉤状突起周囲の結節影は転移リンパ節であった．副乳頭部NETは腫瘍径が小さくても高率にリンパ節転移をきたすため，安易な縮小手術をすべきではないと考えられた．This publication has 20 references indexed in Scilit:
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