十二指腸カルチノイドの1例

Duodenal Carcinoid, a Case Report

　1907年S. Oberndorferにより命名されたカルチノイドは初め良性腫瘍と考えられていたが，1931年Cookeはカルチノイドで転移を有する例を集めて報告し，それ以後，転移に関する報告は増加し，最近ではslow growingの悪性腫瘍という概念が一般化している．本邦における本腫瘍の報告は欧米に比し，いまだ少なく，ことに上部消化管より発生したものは稀である．最近，われわれは十二指腸粘膜下腫瘍の診断で，開腹し，組織学的に本腫瘍と確定しえた症例を経験したので報告する．

　A 68-year-old woman was admitted with chief complaints of epigastralgia and tarry stool. There was no Carcinoid syndrome in her history. Barium enema and endoscopic examination of the upper gastrointestinal tract revealed a submucosal tumor in the second portion of the duodenum. Celiac angiogram showed remarkable vascular neoformation arising from the gastroduodenal artery. A well-defined 4×2.5 cm sized dense tumor stain was observed. Dilated and regular draining veins were observed. Urine 5-HIAA levels were not elevated. A submucosal solid tumor, 3.5×2.4×2.0 cm, wes removed. Its cut surface showed yellow-brown color. Microscopic examination revealed Carcinoid composed of tumor cells of uniform size with island-like, cord-like or rosette-like structures.

　Both argyrophil reaction by Sevier-Munger method and argentaffin reaction by Fontana-Masson method were negative.