十二指腸カルチノイドの1例

Carcinoid of the Duodenum, a Case Report

　本邦における消化管カルチノイドの報告例はしだいに増加しつつあるが，十二指腸カルチノイドは，平林ら（1973）の集計によればまだ15例にすぎない．われわれも最近十二指腸カルチノイドの1例を経験したのでその他の報告例をあわせ，本症の病態と臨床像に関して検討を加える．

　A case of carcinoid tumor in the duodenum is described in a man 58 years of age who was detected to harbor a submucosal tumor in the duodenum when he underwent gastric mass screening although he had no symptoms to complain of. The histologic diagnosis after the surgical intervention was carcinoid.

　Study of 18 cases of duodenal carcinoid including the present one so far reported in Japan shows that the age varies from 12 to 75 years. The male far outnumbers female in a ratio of 15 : 3. The predilection site is overwhelmingly the first limb (14 cases), followed by the second portion (4 cases). The third and fourth portions were free from it. Study of the size of the tumor and the degree of its spread shows that three cases with infiltration in the muscularis mucosae were more than 3.1 cm in tumor diameter, while metastasis was found in two cases, in one less than 1 cm and in another more than 4 cm long in diameter. Its clinical symptoms were variegated includig epigastric pain, but they were mostly traced back to concomitant peptic ulcer. Its diagnosis has never been established prior to surgical exploration. Surgery consists fundamentally in the removal of the tumor.

　There is every reason to expect that prolongation of life in patients with metastasis can be accomplished by by-pass operation of the digestive tract.