[A case of endocrine cell carcinoma in the duodenal bulb]

A 73-year-old man was admitted to our hospital due to weight loss and melena. Roentgenograms and endoscopy showed a Borrmann type 2 tumor occupying the entire duodenal bulb. Histological findings of the lesion (H-E stain) showed poorly differentiated adenocarcinoma. Almost the entire specimen showed positive staining granules for Grimelius stain. Ultrastructurally, remarkable endocrine granules covered a layer of the limited membrane (membrane-bound granule) in the tumor cell. We diagnosed endocrine cell carcinoma. Since it was difficult to operate due to age and invasion to the fundus of the gall-bladder and the pancreatic head, we treated this case by chemotherapy.