Image of the Month—Quiz Case | Gastroenterology | JAMA Surgery | JAMA Network
[Skip to Navigation]
Sign In
Citations 0
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.



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 
Abdominal computed tomographic scan.

Abdominal computed tomographic scan.

Figure 2 
Somatostatin receptor scintigraphy.

Somatostatin receptor scintigraphy.

What Is the Diagnosis?

A.  Peutz-Jegher hamartoma

B.  Sporadic duodenal macrogastrinoma

C.  Celiac disease

D.  Duodenal vipoma