Primary common bile-duct carcinoid

Little, J. M.; Gibson, Alan; Kay, A. W.

doi:10.1002/bjs.1800550221

Cited by 41 publications

(10 citation statements)

References 5 publications

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“…Presenting symptoms (i.e., jaundice, biliary colic, abdominal or back pain, and weight loss) seem to be directly related to tumor invasion of adjacent structures or to metastases [13,18,21,34]. In only three previous cases, urinary 5-hydroxyindoleacetic acid (5-HIAA) was measured and found slightly elevated [29,32,50]. One patient had a history of recurrent duodenal and gastric ulcers, with immunohistochemistry and electron microscopy detecting abundant gastrin production and limited synthesis of serotonin and pancreatic polypeptide [35].…”

Section: Discussionmentioning

confidence: 97%

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Well-differentiated endocrine tumor of the distal common bile duct: a case study and literature review

et al. 2006

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Primary carcinoid tumors of the extrahepatic biliary tree are exceedingly rare, accounting for 0.2-2% of all digestive carcinoids. The authors in this study describe a case of biliary duct primary well-differentiated endocrine tumor in a 30-year-old man with symptoms of biliary obstruction and watery diarrhoea. Abdominal ultrasound showed a 2-cm solid lesion in the head of the pancreas, compressing the distal common bile duct. A computed tomography scan confirmed these findings, revealing the hypervascular pattern of the tumor. Gastrointestinal hormonal screening demonstrated an increase in plasma serotonin. The patient underwent standard pylorus-preserving pancreatoduodenectomy. Pathological examination showed a neuroendocrine tumor of the distal common bile duct measuring 1.8 cm in greatest dimension. The tumor cells were immunopositive for neuron-specific enolase (NSE), chromogranin A, synaptophysin, serotonin, and cytokeratin. Stains for gastrin and somatostatin were negative. Seven years later, the patient is well, with no evidence of disease. Given the site of these tumors and the difficulty in differentiating them from periampullary lesions, decisions as to the appropriate surgical approach may be problematic. After an exhaustive review of the literature, the authors conclude that pancreatoduodenectomy is the treatment of choice.

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Section: Discussionmentioning

confidence: 97%

“…Most neuroendocrine tumors of the common bile duct were found accidentally (i.e., incidentalomas) during biliary tract operations performed for other indications. An endocrine choledochal tumor was suspected preoperatively in three patients with elevated urinary 5-HIAA [29,32,50].…”

Section: Discussionmentioning

confidence: 99%

Well-differentiated endocrine tumor of the distal common bile duct: a case study and literature review

et al. 2006

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“…In dogs, carcinoids have been reported in the intestines and lungs [6, 14, 29,401. Carcinoids of the hepatobiliary system are rare in man, and are located mostly in the gall bladder and extrahepatic bile ducts [3,12, 18,23, 371. There are few reports of carcinoids arising from the intrahepatic tissue; the source of these neoplasms is considered to be the intrahepatic bile ducts [2,3, 7, 111.…”

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confidence: 99%

Canine Hepatic Carcinoids

et al. 1981

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Abstract. In 110 primary hepatic neoplasms in the dog, 15 carcinoids were diagnosed. Diffuse involvement of all liver lobes with severe hemorrhage and necrosis was seen in all cases. The neoplasms had three distinct histologic patterns: solid nests; cords or ribbons; and an alveolar pattern with rosettes. In all three groups there was fibrovascular stroma that was hyalinized, mineralized, and thick in some places. The neoplastic cells were relatively uniform, polygonal to spindle-shaped, with eosinophilic, granular cytoplasm and vesiculated nuclei. Mitotic activity varied among the three groups. Argyrophilia was seen in all specimens stained with modified Grimelius stain. Metastasis occurred in 14 of 15 dogs (93.3%); the peritoneal wall and adjoining lymph nodes were the most common sites.Carcinoid neoplasms originate from neuroectodermal tissue, or from amine precursor uptake and decarboxylation (APUD) cells [4,22,341 [5, 8-10, 17, 22, 27,36,38, 41-46].Carcinoids are rare in animals, and are reported mostly in the gastrointestinal tract [ I , 13,19,21,471. In dogs, carcinoids have been reported in the intestines and lungs [6, 14, 29,401. Carcinoids of the hepatobiliary system are rare in man, and are located mostly in the gall bladder and extrahepatic bile ducts [3,12, 18,23, 371. There are few reports of carcinoids arising from the intrahepatic tissue; the source of these neoplasms is considered to be the intrahepatic bile ducts [2,3, 7, 111. Hepatic carcinoids have not been described in the dog; among domestic animals, one hepatic carcinoid has been recorded in a cow [35]. Materials and MethodsThe I10 primary hepatic neoplasms found in 12,245 canine necropsies were studied as described (301. Of these neoplasms. I5 were diagnosed by histologic and histochemical criteria as carcinoids.Formalin-fixed tissues were processed routinely, and sections 4 to 6 p n thick were stained with hematoxylin and eosin (HE). mucicarmine. periodic acid-Schiff (PAS). and Congo red. Six specimens. two from each of the three histologic groups. were stained with modified Grimelius stain (Pathology Laboratory. Memorial Sloan-Kettering Cancer Center. New York) [201. ResultsFor age, sex and breed distribution see table I. The ages and sexes of 14 of the 15 dogs were available: 10 dogs were under 10 years old, three between 4 and 5, and seven between 6 and 10 years old; four dogs were older than 10 years. There was no sex or breed predilection.Clinical signs were recorded for 12 of the 15 dogs. Seven dogs had anorexia, six ascites, five weight loss, five polydypsia and polyuria, four jaundice, and four diarrhea. Melena and hematbchezia, hematuria and seizures also were seen. Hepatomegaly was not seen clinically in any of the dogs with carcinoid, and none of the clinical signs were specific for carcinoids.Laboratory findings are shown in table 11, and include high white blood cell counts in nine of ten dogs, low red blood cell counts in four of seven, low hemoglobin values in four of seven, and marked increases in serum alkaline ph...

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“…They appear, however, to be slow growing and prolonged survival has been reported without treatment. 7 Most biliary carcinoids are argentaffin negative and in keeping with this no carcinoid syndrome has been reported in association with these tumours. By definition all are Grimelius positive and this establishes them as true carcinoids.…”

Section: Discussionmentioning

confidence: 58%