Radiological Case

GIST of the Duodenum and Proximal Jejunum With an Ampullary Neuroendocrine Tumor

Mohammed Mirza, MD; Joshua Boulter; Alula Tesfay, MD


Appl Radiol. 2020;49(5):49-51. 

In This Article

Imaging Findings

Abdominal radiographs were unremarkable. Contrast-enhanced CT (CECT) of the abdomen revealed a right renal subcapsular hematoma and multiple masses in the duodenum. The largest of these being a 2cm mass in the second portion of the duodenum, along with numerous subcutaneous soft-tissue nodules (Figure 1).

Figure 1.

Axial (A) and coronal (B) contrast-enhanced CT of the abdomen demonstrates periampullary diodenal mass (green arrow) and multiple subcutaneous nodules overlying the anterior abdominal wall (white arrow).

The same patient presented 3.5 years later with diffuse abdominal pain. Repeat CECT of the abdomen revealed pancreaticobiliary obstruction along with findings suggestive of gallbladder hydrops secondary to a 2cm duodenal mass and an obstructing left nephrolith (Figure 2). Surgery revealed a neuroendocrine neoplasm of the ampulla of Vater and five tumors in the duodenum and proximal jejunum, the largest measuring 3.7cm.

Figure 2.

Axial (A) and sagittal (B) contrast-enhanced CT of the abdomen demonstrates obstructing periampullary duodenal mass (red arrow) with gallbladder hydrops (blue arrow).