Segmental resection of small intestine and exstirpation of the metastatic masses was performed. Postoperative period was uneventful. Cytotoxic chemotherapy in this adjuvant setting has not been recommended. Small intestinal carcinoid tumor has to be considered as a rare cause of gastrointestinal bleeding with melaena or hematochezia. Nevertheless, bleeding is a relatively rare early symptom of patients with small intestine carcinoid tumor.
Ultrasonic diagnosis is expedient as a screening method.
Percutaneous transhepatic cholecystocholangiostomy or tumor stenting is expedient as a preoperative method of biliary tract decompression. Whether this is true of neuroendocrine tumors such as gastrinomas is unclear. To address this question we analyzed the gastrinomas from 44 patients for p16INK4a gene mutations and correlated the results to the tumor's biological behavior, growth pattern, and aggressiveness. No homozygous deletions were found. These results indicate that methylation of the p16INK4a gene is the most common gene alteration described to date in gastrinomas.