A CASE OF CARCINOID TUMOR OF THE DUODENUM WITH DIFFUSE SPLENIC METASTASES SHOWING MULTIPLE HYPERECHOIC NODULES ON ULTRASONOGRAM

Abstract

Carcinoid tumors arising in the duodenum are relatively uncommon. We reported a case of duodenal carcinoid with diffuse splenic metastases showed a peculiar ultrasonogram. A 75-year-old woman was hospitalized because of left abdominal pain and a weight-loss. Ultrasonogram revealed a hepatosplenomegaly and the spleen filled with many round nodules son the ultrasonogram. In spite of several image examinations and aspiration cytologic examinations with fine needle of the spleen, liver and ascites, final diagnosis was unknwon. After three months from admission she died becaused of hepatorenal failure. Autopsy revealed a carcinoid tumor localized to the duodenal bulb, and metastases in multiple organs such as the liver, pleen, ovary, kidney, lung and lymphnodes. Especially the spleen was severely swelling and filled with multiple metastatic nodules, which showed a good coincidence with the ultrasonographic findings. Hepatic metastasis of carcinoid has been well decribed but splenic metastasis is rare. We think this is the first case in which diffuse splenic metastases of duodenal carcinoid could be visualized by ultrasound.