Abstract
A case of carcinoid of the accessory papilla which is extremely rare is reported. A 52-year-old man consulted another a hospital for hematemesis and was diagnosed as gastric ulcer. During the treatment of gastric ulcer, a submucosal tumor of the duodenum was detected and he was sent to the hospital. The tumor was located on the anterior wall of the duodenal second portion, at 2.5cm oral side of Vater papilla, measuring about 10mm in diameter. Accessory papilla was not identified on examinations. Biopsy showed carcinoid cells invaded the smooth muscle. Pancreaticoduodenectomy with adjacent lymph node dissection was performed. Resected specimen showed the carcinoid tumor invaded submucosal layer in the accessory (papilla, measuring 12×12mm, with adjacent lymoh node metastasis. The careful choice of treatment is needed in treatment of carcinoid tumor near the accessory papilla, even if, it is small in size and not invaded to muscular layer. And the smooth muscle in biopsy specimen is a special bundle of smooth muscle in the accessory papilla like a sphincter of Oddi.
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