case_images: PMC6381881_01
case_images: a, Upper endoscopic examination: the tumor size was 8 mm on the duodenal bulb. b, Pancreaticoduodenectomy was performed: the black arrow indicates the tumor. c. The tumor comprises small-sized cells with granular eosinophilic cytoplasm, central round nuclei, coarse-clustered chromatin and inconspicuous nuclei (hematoxylin and eosin stain, x200). Immunohistochemical staining. The tumor cells show a Ki-67 index of approximately 5% (d) with positive expressions for chromogranin A (e) and synaptophysin (f).
case_images: cro-0012-0014-g01.jpg
case_images: PMC6381881_01_cro-0012-0014-g01.jpg
case_images: F1
case_images: A 57-year-old man underwent pancreatoduodenectomy for duodenal bulb NET (G2) (T1 N1 M0 Stage IIIb) in December 2015 (Fig. 1).
case_images: Octreoscan: comparison 1 year after administration of streptozocin monotherapy before (a) and after 42 courses (b).
case_images: cro-0012-0014-g02.jpg
case_images: PMC6381881_01_cro-0012-0014-g02.jpg
case_images: F2
case_images: The disease was judged to PD (Fig. 2a). One year later, an octreotide scan showed a stable disease (Fig. 2b).
case_images: Treatment course.
case_images: cro-0012-0014-g03.jpg
case_images: PMC6381881_01_cro-0012-0014-g03.jpg
case_images: F3
case_images: However, 1 year later, because CA 19-9 levels increased, the STZ dose was increased to 1,500 mg/m2, after which the levels normalized again for the second time (Fig. 3).