A case of duodenal carcinoma presenting as a submucosal tumor.
This paper describes a patient with duodenal carcinoma showing the features of a submucosal tumor, leading to difficulty in making an accurate preoperative diagnosis. A 63-year-old woman was admitted for investigation of a duodenal mass. An examination of the upper gastrointestinal tract revealed a semicircular compression of the stomach and the duodenum. Endoscopy of the stomach and duodenum disclosed a hemispherical tumor with a deep ulcer in the apex. Computer tomography revealed a tumor of about 5 cm in diameter at the same site. Laparotomy was performed under the tentative diagnosis of a submucosal tumor. A tumor was found occupying the duodenum, which compressed the gastric antrum exteriorly, and was also adherent to the head of the pancreas by direct invasion. A curative resection was performed by combining a pancreatoduodenectomy with a transverse colectomy along with regional lymph node clearance. A microscopic examination showed that the tumor contained neoplastic cells growing in a tubular pattern, particularly in its peripheral regions. Thus, this lesion was finally diagnosed as primary adenocarcinoma of the duodenum.
First Department of Surgery, Fukui Medical School, Japan.
Y
Y
Kojima
T
T
Kobayashi
M
M
Note
G
G
Nakagawara
T
T
Kato
Y
Y
Kohli
H
H
Sugihara
Y
Y
Imamura
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D004379:Duodenal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D004384:Duodenoscopy; D004386:Duodenum / Q000473:pathology; D005260:Female; D005773:Gastroscopy; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D014057:Tomography, X-Ray Computed