The patient, a 75-year-old man, presented with severe upper gastrointestinal hemorrhage. He had a history of hypertension, diabetes mellitus, chronic obstructive pulmonary disease with oxygen-dependent emphysema, and previous episodes of pulmonary embolism and auricular ®brillation. Cardioversion had been performed, and the patient had a pacemaker and was taking coumadin.This extremely sick man with multiple medical conditions was initially resuscitated by means of¯uid administration and blood transfusion. On endoscopic examination, a fungating tumor was found in the duodenum. At the same time, profuse bleeding was observed from the site of the tumor. Examination of a biopsy specimen revealed a carcinoid tumor (Fig. 1).Tumors of the small intestine and duodenum are rare. In 1983, Williamson, Welch, and Malt [5] followed (for 64 years) and reported 171 patients from Massachusetts General Hospital. Those included 68 with adenocarcinomas, 41 with primary lymphomas, 50 with carcinoids, and 12 with sarcomas.
strand cDNAs. SERPINB11 mRNA level were quantified by real-time PCR in HNSCC cells. RESULTS: Four SERPINB11 clones encoded for a fulllength serpin containing 8 exons and harbored polymorphisms in key structural elements. SERPINB11 mRNA is expressed in squamous cell epithelial cell line, HaCaT, and is significantly down-regulated in HNSCC cell lines. CONCLUSION: SERPINB11 is a novel clade B serpin that is expressed in squamous epithelium and is down-regulated in HNSCC cells. SIGNIFICANCE: Loss of expression of SERPINB11 may play a role in the malignant progression of HNSCC.
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