Carcinoid Tumor Diagnosis
Duodenal Carcinoid Tumor occurs rarely, and till today, there is no serious case were observed that required the surgical treatment. When Duodenal Carcinoid Tumor was pathological diagnosed for the 24 patients, then around eighty percent of them were found to be measuring only 2 cm diameter. Around 85% of the patients suffer from the submucosa and mucosa.
In a case of 13 patients, their lymph nodes were examined to find the Duodenal Carcinoid Tumor, but only the lymph node metastases were observed in 7 patients. Among them, only 2 patients have tumors having size smaller than 1 cm that was like the size of submucosa. After the continuous period of 46 months, the disease survival rates exceed to 100% and only two patients have observed the reoccuring the regional lymph nodes. During the time, no patients were found suffering from carcinoid syndrome or distant metastases.
The authors of the above case have done study that in the patients suffering from tumors and found that the duodenal carcinoids tumor are inactive. However, the lymph node metastases could not be determined on the basis of the tumor size and their effect on the survival rate has not yet clear.
Duodenal Carcinoid Tumor were treated by using the endoscopic excision that was found as an appropriate method of the primary stage treatment for the tumor having size less than 2 cm. The full thickness excision were operated in the tumors having size in between 1 cm to 2cm.
Duodenal Carcinoid Tumor that have size of 1 cm could not be removed completely at the first treatment of endoscopic. Therefore, before using the endoscopic resection, they have been examined under the endoscopic ultrasonography, so that it does not affect the areas beyond the submucosa.
Duodenal Carcinoid Tumor that have size more than 2 cm needs to be managed properly as it seems to be problematic. However, this type of tumor has been treated by using the regional lymphadenectomy and full thickness excision. The Lymphadenectomy could even be performed as the lymph nodes are a major cause of these tumors.
According to some authors, Duodenal Carcinoid Tumor that are larger than 2 cm needs to be treated using Lymphadenectomy along with the lymph nodes on the basis of below locations:
- If the anterior present, to the inferior vena cava, pancreatic head or the posterior present at the duodenum.
- Portal vein and posterolateral present at the bile duct.
- Anterior present at the common hepatic artery.
During the surgery time, the imagining studies that have found the abnormal lymph nodes should be cutted down by noticing the primary tumor size. This is because, only small history is known about the tumor apart from the nonoperative management and lymph node metastates. The lymph node patients were given the continued radiographic surveillance rather the primary tumor size.
The periampullary and ampullary Duodenal Carcinoid Tumor needs to be observed minutely as they are alike histologically, clinically and immunohistochemically compare to the carcinoid tumors that are present in other areas, in duodenum. These types of tumour were treated in a different way and are unpredicted.