[Residual gastric carcinoid complicated with multiple endocrine neoplasia and Cushing's syndrome--a case report]

A 51-year-old man had had his stomach resected 10 years earlier due to gastric ulcer. Ten months before the present illness, he complained of a puffy face and edema of the both lower extremities. Hyperparathyroidism with a high level of parathyroid hormone (0.75 ng/ml) was diagnosed. A submucosal tumor was noted at the residual stomach, and histologically, carcinoid was preoperatively confirmed by endoscopic study. Total gastrectomy with radical lymphadenectomy was performed, and concomitantly a small tumor noted at the body of the pancreas was also extirpated. In addition, three and a half of all four parathyroid glands were resected. Histologically, the pancreatic tumor was adenoma, with the parathyroid glands showing only hyperplastic changes. Subsequently, during the postoperative course, Cushing's syndrome was further diagnosed, and the patient is now under follow-up study.