Clin Endosc.  2013 Nov;46(6):656-661.

Endoscopic Treatment of Duodenal Neuroendocrine Tumors

• Kim SH
• Park CH
• Ki HS
• Jun CH
• Park SY
• Kim HS
• Choi SK
• Rew JS

Abstract

Duodenal neuroendocrine tumors (NETs) are rare neoplasms. In this study, the medical records of 14 patients with duodenal NETs diagnosed at Chonnam National University Hospital from July 2001 to August 2011 were reviewed and analyzed retrospectively. Four patients were diagnosed in the first 5 years, and 10 patients were diagnosed in the latter 5 years of the study. Ten of 12 patients (83.3%) who underwent endoscopic biopsy were confirmed to have NET before resection. Endoscopic resection was performed in 12 patients, surgical resection in one patient, and regular follow-up in one patient who refused resection. None of the patients showed recurrence or distant metastasis. Duodenal NETs are increasingly observed and are mostly detected during screening upper gastrointestinal endoscopy. Careful endoscopic examination and biopsy can improve the diagnostic yield of NETs. Most well-differentiated, nonfunctional duodenal NETs that are limited to the mucosa/submucosa can be treated effectively with endoscopic resection.

Keyword

Neuroendocrine tumors; Endoscopic mucosal resection; Duodenum

MeSH Terms

Biopsy
Duodenum
Endoscopy, Gastrointestinal
Follow-Up Studies
Humans
Mass Screening
Medical Records
Neoplasm Metastasis
Neuroendocrine Tumors*
Recurrence
Retrospective Studies

Figure

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  Fig. 1 (A-D) Morphologic findings and resection techniques for duodenal neuroendocrine tumors (A, patient 6; B, patient 7; C, patient 9; D, patient 10). (Ac) Endoscopic mucosal resection (EMR) with circumferential precutting (EMR with precutting): after submucosal injection and circumferential mucosal incision, snaring was performed. (Bc) Endoscopic submucosal dissection: after submucosal injection, circumferential mucosal incision was performed. (Cc) EMR with ligation: band ligation was performed. (Dc) EMR: snaring was performed.

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  Fig. 2 (A-D) Endoscopic findings and coronal computed tomography (CT) scans before and after endoscopic resection (patient 4). (A, C) Endoscopy and CT image show a submucosal mass (black arrows). (B, D) Follow-up endoscopic and coronal CT images show no evidence of recurrence 62 months after resection.

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