Ampullo of Vater의 Somatostationoma
Somatostationoma of the Ampullo of Vater
이효원, 김현철, 송옥평, 임철완, 신응진, 조규석, 주종우, 고은석, 권계원, 홍수진,
소속 상세정보
이효원 ( Lee Hyo-Won )
순천향대학교 부천병원 외과학교실
김현철 ( Kim Hyung-Chul )
순천향대학교 의과대학 부천병원 외과학교실
송옥평 ( Song Ok-Pyung )
순천향대학교 의과대학 부천병원 외과학교실
임철완 ( Lim Chul-Wan )
순천향대학교 의과대학 부천병원 외과학교실
신응진 ( Shin Eung-Jin )
순천향대학교 의과대학 부천병원 외과학교실
조규석 ( Cho Gyu-Seok )
순천향대학교 의과대학 부천병원 외과학교실
주종우 ( Chu Chong-Woo )
순천향대학교 부천병원 외과
고은석 ( Koh Eun-Seok )
순천향대학교 의과대학 부천병원 병리학교실
권계원 ( Kwon Kye-Won )
순천향대학교 의과대학 병리학교실
홍수진 ( Hong Su-Jin )
순천향대학교 의과대학 내과학교실
KMID : 0371320040660030251
Abstract
Somatostatinoma is a rare form of neuroendocrine tumor that was first described in 1977. Most tumors have involved the pancreas, and gastrointestinal tract involvement is rare. Somatostatinomas of the ampulla of Vater are extremely rare and present distinct clinical and pathologic differences. Pancreatic somatostatinoma has been associated with a clinical syndrome of dyspepsia, mild diabetes, cholelithiasis, steatorrhea, and hypochlorhydria, but duodenal somatostatinoma, in general, has been clinically silent. A further contrast is that duodenal carcinoid tumors, mainly gastrinoma, tended to be benign, whereas ampullary carcinoid tumors, mainly somatostatinoma, exhibited malignant behavior. Therefore, definite diagnosis is important for treatment and prognosis, and is performed by image study, immunohistochemistry and electron microscopic examination. We report a case of somatostatinoma of the ampulla of Vater in a 51-year-old male. He complained of generalized abdominal pain for a few days. Gastrofiberscopically, a 1.2 cm sized bulging mass was observed on the ampulla of Vater. Radiologically, on abdomen CT, a protruding enhancing mass was revealed in the duodenum, In octreoscan, there was an abnormal focus off increased radiouptake in the infrahepatic area. He underwent a pancreatoduodenectomy. Grossly, the mass was an intraluminary protruding polypoid submucosal mass with focal ulceration in the ampulla of Vater. Histologically, it showed well-differentiated nonpleomorphic tubular cell nest and psammoma bodies. Immunohistochemically, the tumor cells showed a neuroendocrine nature with synaptophysin immunostain and intense staining only for somatostatin.
키워드
Somatostatinoma;Vater씨 팽대부;Ampulla of Vater
원문 및 링크아웃 정보
등재저널 정보