Vol. 5, Issue 10 (2019)
Carcinoid tumor of the 4th part of duodenum a case report and review of literature
Author(s): Ammar Alselwi, Fayed Al-Yousofy, Afif Al-Nabhi
Abstract: Carcinoid tumors are uncommon well differentiated neuroendocrine tumors. Primary duodenal carcinoids account for less than 2% of all gastrointestinal carcinoids. Duodenal carcinoids are seldom associated with carcinoid syndrome. We reported a case of duodenal carcinoid tumor in a 25-year-old female presented by upper abdominal pain and intestinal obstruction. The tumor made wide spread intrabdominal and pelvic metastasis although the primary was small and of well differentiated neuroendocrine category. Surgical excision of the primary tumor, histopathology and immunohistochemistry proved the diagnosis. The case underwent postoperative targeted therapy using Everolimus (Afinitor®). CT scan, 5-hydroxytryptamine (5HT) and 5-hydroxyindole acetic acid (5-HIAA) in urine were used for staging the tumor, confirming diagnosis and follow up. There was an excellent response after 3 months of postoperative targeted therapy without any recurrence locally, no lymph nodes, and complete disappearance of metastatic tumor in liver, peritoneum and pelvis. We recommended targeted therapy using afinitor for at least 6 months or more according patient response.