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Special Feature
January 2011January 17, 2011

Image of the Month—Quiz Case

Author Affiliations

Author Affiliations: Department of Digestive Surgery, University Hospital Haut Leveque, Pessac, France.




Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2011

Arch Surg. 2011;146(1):113. doi:10.1001/archsurg.2010.298-a

A 74-year-old man was hospitalized for chronic diarrhea and weight loss. His medical history included hypertension and peptic gastric ulcers, which were treated with atenolol and proton pump inhibitors, respectively. He had no history of travel in tropical regions. Laboratory test results and a colonoscopy were normal. An abdominal computed tomographic scan revealed evidence of a hypervascularized mass, 4 cm in diameter, located in the first part of the duodenum associated with a pericephalic pancreatic adenopathy, 22 mm in diameter (Figure 1), both hyperfixating on a somatostatin receptor scintigraphy (Figure 2). There were no other fixating lesions on the somatostatin receptor scintigraphy.

Figure 1
Image not available

Abdominal computed tomographic scan.

Figure 2
Image not available

Somatostatin receptor scintigraphy.

What Is the Diagnosis?

A.  Peutz-Jegher hamartoma

B.  Sporadic duodenal macrogastrinoma

C.  Celiac disease

D.  Duodenal vipoma