Table 1.
Histology, clinical presentation, and CT appearance of duodenal carcinoid tumors in the study population
| Patient | Histologic type | Signs and Symptoms at presentation | Associated clinical syndrome |
Number of duodenal carcinoids at CT |
CT appearance of primary mass |
Metastases at CT |
|---|---|---|---|---|---|---|
| 1 | Carcinoid tumor (low-grade neuroendocrine neoplasm) | Nonspecific left upper quadrant pain | None | None | Not seen | None |
| 2 | WHO grade I, well-differentiated neuroendocrine carcinoid tumor | Long standing reflux and refractory reflux | None | None | Not seen | None |
| 3 | Carcinoid tumor (low-grade neuroendocrine neoplasm) | Nonspecific reflux and mild anemia | None | 6 | Polypoid intraluminal mass | None |
| 4 | Well-differentiated neuroendocrine neoplasm, somatostatinoma | Abnormal liver function tests | None | 1 | Polypoid intraluminal mass | None |
| 5 | Carcinoid tumor (low-grade neuroendocrine neoplasm) | GI bleeding- melena | None | None | Not seen | None |
| 6 | Low-grade neuroendocrine neoplasm | Asymptomatic, incidentally noted dilated biliary tree on CT for kidney stones | None | 1 | Polypoid intraluminal mass | Enhancing lymphadenopathy adjacent to third portion of the duodenum, liver metastases |
| 7 | Carcinoid tumor (low-grade neuroendocrine neoplasm) | Not specified in medical records | None | 1 | Polypoid intraluminal mass | Four large enhancing lymph nodes adjacent to third portion of the duodenum, larger than primary |
| 8 | Well-differentiated neuroendocrine tumor with features of a somatostatinoma | Weight loss and fatigue | NF-1 | 1 | Wall thickening | Enhancing lymphadenopathy in the root of the mesentery |
| 9 | Carcinoid tumor (low-grade neuroendocrine neoplasm) | Dysphagia-like symptoms | None | 1 | Polypoid intraluminal mass | Small portal caval enhancing lymph node, small hypervascular liver metastases |
| 10 | Carcinoid tumor (low-grade neuroendocrine neoplasm) | Bright red blood per rectum, GI bleed | None | 1 | Polypoid intraluminal mass | None |
| 11 | Three well-differentiated duodenal gastrinomas | Recurrent nausea, abdominal fullness, severe diarrhea, reflux | MEN-1 and ZES | 2 | Polypoid intraluminal mass | Small enhancing lymph node inferior to the second portion of duodenum |
| 12 | Carcinoid tumor (low-grade neuroendocrine neoplasm) | Abdominal pain, diarrhea, vomiting | None | 1 | Polypoid intraluminal mass | Small enhancing adjacent lymph nodes |
| 13 | Low-grade gastrinomas | Prior severe nausea, vomiting, and diarrhea, asymptomatic currently | MEN-1 and ZES | 14 | Polypoid intraluminal mass | Several adjacent enhancing lymph nodes |
| 14 | Carcinoid tumor (low-grade neuroendocrine neoplasm) | Asymptomatic, noted over work up for shortness of breath and occasional right upper quadrant pain | None | None | Not seen | Several adjacent enhancing lymph nodes |
| 15 | Somatostatinoma (low-grade neuroendocrine neoplasm) | Long history of intermittent right upper quadrant pain, also fatigue, and weight loss | None | 1 | Polypoid intraluminal mass | Adjacent enhancing lymph nodes especially portal caval |
| 16 | Well-differentiated carcinoid | Abdominal discomfort | None | 1 | Polypoid intraluminal mass | Small adjacent enhancing lymph nodes |
| 17 | Carcinoid tumor | Weight loss and guaiac positive stools | None | 1 | Polypoid intraluminal mass | None |
| 18 | Well-differentiated neuroendocrine neoplasm | Intermittent epigastric pain, nausea, and vomiting | None | 1 | Polypoid intraluminal mass | None |
| 19 | Carcinoid tumor of the duodenum | Abdominal pain, dyspepsia, diarrhea | None | 1 | Polypoid intraluminal mass | Enhancing lymphadenopathy on prior resection by third portion of the duodenum, but none on CT scan prior to Whipple procedure |
| 20 | Incidental well-differentiated endocrine neoplasm | Painless jaundice | None | 1 | Polypoid intraluminal mass | None, has pancreatic cancer |
| 21 | Small carcinoid tumor | Painless jaundice | None | None | Not seen | None, has pancreatic cancer |
| 22 | Well-differentiated neuroendocrine neoplasm | Abnormal liver function tests | None | 1 | Wall thickening | Small adjacent mildly enlarged enhancing lymph nodes |
| 23 | Well-differentiated neuroendocrine neoplasm | Severe epigastric pain and vomiting | None | 1 | Polypoid intraluminal mass | None |
| 24 | Carcinoid tumor | Weight loss and steatorrhea | None | 1 | Polypoid intraluminal mass | None |
| 25 | Well-differentiated neuroendocrine neoplasm | Anemia | NF-1 | 1 | Polypoid intraluminal mass | None |
| 26 | Well-differentiated neuroendocrine neoplasm | Not specified in the medical records | None | 1 | Wall thickening | None |
| 27 | Well-differentiated neuroendocrine neoplasm | Asymptomatic, incidentally noted after trauma | None | 1 | Wall thickening | Large enhancing portal caval lymph node |
| 28 | Carcinoid tumor (low-grade neuroendocrine neoplasm) | Nausea, vomiting, abdominal pain | NF-1 | 1 | Polypoid intraluminal mass | None |
NF-1 neurofibromatosis type-1, MEN-1 multiple endocrine neoplasia type-1, ZES Zollinger–Ellison syndrome, CT computed tomography, GI gastrointestinal