Duodenal Carcinoid with Small LN скачать в хорошем качестве

Duodenal Carcinoid with Small LN

A 45 years old male with a 1 cm polyp in the roof of the duodenal bulb proved to be NET by Endoscopic biopsies, referred for EUS before EMR. The muscularis propria is free, however there is a nearby LN firm on elastography, although small in size (0.4 x 0.6 cm). What is the best management? The LN looks tiny, may be 2 mm and sampling it will be difficult and it is not likely coming from the 4x6 mm Superficial net. We would exclude other net lesions with mri and then would go for lesion resection (ESD or ftrd), if G1 stage and R0 resection, i would do close follow up for the lymph node which might be reactive.