Metachronous duodenal neuroendocrine neoplasms after endoscopic mucosal resection

Abstract

Summary Duodenal neuroendocrine tumors (D‐NETs) may or may not be associated with a functional clinical syndrome. The term D‐NETs includes all duodenal tumors with neuroendocrine features as determined by histological/ immunohistochemical methods including positivity for neuroendocrine cytosolic markers (neuron‐specific enolase, or secretory vesicle proteins (chromogranin A (CgA), synaptophysin)). More than 90% of all D‐NETs arise in the first and second part of the duodenum. Approximately 20% of D‐NETs occurs in the periampullary region. Most D‐NETs are asymptomatic and incidentally detected during upper gastrointestinal (GI) endoscopy examinations for symptoms unrelated to the carcinoid tumor. D‐NETs account for 2% ‐ 5% of GI neuroendocrine tumors, and usually present as solitary small lesions confined to the duodenal submucosa. Endoscopic treatment is generally recommended for D‐NETs less than 10 mm as it is associated with a low frequency of lymph node invasion and distant metastases. However, the report of metachronous or synchronous concurrence of D‐NETs is scarce. Herein, we present a case of metachronous duodenal neuroendocrine tumor status successfully treated by hybrid endoscopic submucosal dissection. Copyright © 2017, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.