EMR of large periampullary neuroendocrine tumor

摘要

A 74-year-old man with a history of hypertension,chronic kidney disease, and diabetes mellitus type 2 presented with a 2-day history of melena. His hemoglobinlevel remained unchanged during hospitalization. He underwent an upper endoscopy that showed a 2- to 3-cmperiampullary mass (Fig. 1A) concerning for malignancyjust distal to the ampulla (Figs. 1B and C). Examinationof initial pinch biopsy specimens showed negativeresults. Subsequent EUS showed a 21- by 11-mmmass that was mucosal in origin without invasionthrough the muscularis propria. Examination of corebiopsy specimens revealed a neuroendocrine (carcinoid)tumor.