Somatostatinoma Presented as Double-Duct Sign
Somatostatinoma is a rare neuroendocrine tumor with an incidence rate of 1 in 40 million people. It presents mostly as asymptomatic tumor diagnosed incidentally on imaging or surgery when evaluating or treating possible causes of abdominal pain. It also can present with vague symptoms, or as a clini...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2019/9506405 |
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| author | Ali Zakaria Nour Hammad Cynthia Vakhariya Michael Raphael |
| author_facet | Ali Zakaria Nour Hammad Cynthia Vakhariya Michael Raphael |
| author_sort | Ali Zakaria |
| collection | DOAJ |
| description | Somatostatinoma is a rare neuroendocrine tumor with an incidence rate of 1 in 40 million people. It presents mostly as asymptomatic tumor diagnosed incidentally on imaging or surgery when evaluating or treating possible causes of abdominal pain. It also can present with vague symptoms, or as a clinical triad of glucose intolerance, steatorrhea, and achlorhydria. The majority of somatostatinomas are present in the pancreatic head, followed by the duodenum, the pancreatic tail, and rarely the ampulla of Vater. The prognosis is poor as more than 77% of cases present as advanced disease with local invasion or distant metastasis. Surgical resection is the main treatment for early stage disease. Other treatment options include somatostatin analogue, molecular targeted therapy, and cytotoxic chemotherapy. The scarcity of somatostatinoma cases led to the lack of fully formulated treatment options. Herein, we present a 43-year old male patient who was referred by his primary care physician to our gastroenterology clinic due to elevated liver function test and double-duct sign on CT scan. We performed an ERCP, which revealed 2 cm ampullary lesion with upstream obstruction. Biopsies were taken and histopathology was unrevealing. He underwent a laparoscopic pancreaticoduodenectomy with histopathology revealed stage IIb somatostatinoma. Treating physicians should hold a high index of suspicion and maintain a broad differential diagnosis of elevated liver enzymes. |
| format | Article |
| id | doaj-art-82d109dc6bc34afa867b255acc2bd0f6 |
| institution | Kabale University |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-82d109dc6bc34afa867b255acc2bd0f62025-08-20T03:37:37ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362019-01-01201910.1155/2019/95064059506405Somatostatinoma Presented as Double-Duct SignAli Zakaria0Nour Hammad1Cynthia Vakhariya2Michael Raphael3Division of Gastroenterology, Providence-Providence Park Hospital and Medical Center, Michigan State University/College of Human Medicine, Southfield, Michigan, USADepartment of Internal Medicine, Providence-Providence Park Hospital and Medical Center, Michigan State University/College of Human Medicine, Southfield, Michigan, USADivision of Hematology & Oncology, Providence-Providence Park Hospital and Medical Center, Michigan State University/College of Human Medicine, Southfield, Michigan, USADivision of Gastroenterology, Providence-Providence Park Hospital and Medical Center, Michigan State University/College of Human Medicine, Southfield, Michigan, USASomatostatinoma is a rare neuroendocrine tumor with an incidence rate of 1 in 40 million people. It presents mostly as asymptomatic tumor diagnosed incidentally on imaging or surgery when evaluating or treating possible causes of abdominal pain. It also can present with vague symptoms, or as a clinical triad of glucose intolerance, steatorrhea, and achlorhydria. The majority of somatostatinomas are present in the pancreatic head, followed by the duodenum, the pancreatic tail, and rarely the ampulla of Vater. The prognosis is poor as more than 77% of cases present as advanced disease with local invasion or distant metastasis. Surgical resection is the main treatment for early stage disease. Other treatment options include somatostatin analogue, molecular targeted therapy, and cytotoxic chemotherapy. The scarcity of somatostatinoma cases led to the lack of fully formulated treatment options. Herein, we present a 43-year old male patient who was referred by his primary care physician to our gastroenterology clinic due to elevated liver function test and double-duct sign on CT scan. We performed an ERCP, which revealed 2 cm ampullary lesion with upstream obstruction. Biopsies were taken and histopathology was unrevealing. He underwent a laparoscopic pancreaticoduodenectomy with histopathology revealed stage IIb somatostatinoma. Treating physicians should hold a high index of suspicion and maintain a broad differential diagnosis of elevated liver enzymes.http://dx.doi.org/10.1155/2019/9506405 |
| spellingShingle | Ali Zakaria Nour Hammad Cynthia Vakhariya Michael Raphael Somatostatinoma Presented as Double-Duct Sign Case Reports in Gastrointestinal Medicine |
| title | Somatostatinoma Presented as Double-Duct Sign |
| title_full | Somatostatinoma Presented as Double-Duct Sign |
| title_fullStr | Somatostatinoma Presented as Double-Duct Sign |
| title_full_unstemmed | Somatostatinoma Presented as Double-Duct Sign |
| title_short | Somatostatinoma Presented as Double-Duct Sign |
| title_sort | somatostatinoma presented as double duct sign |
| url | http://dx.doi.org/10.1155/2019/9506405 |
| work_keys_str_mv | AT alizakaria somatostatinomapresentedasdoubleductsign AT nourhammad somatostatinomapresentedasdoubleductsign AT cynthiavakhariya somatostatinomapresentedasdoubleductsign AT michaelraphael somatostatinomapresentedasdoubleductsign |