title: Adenocarcinoma of the third portion of the duodenum in a man with CREST syndrome.
abstract: BACKGROUND
  CREST (Calcinosis, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly and Telangiectasias) syndrome has been rarely associated with other malignancies (lung, esophagus). This is the first report of a primary adenocarcinoma of the third portion of the duodenum in a patient with CREST syndrome.
  
  
  METHODS
  A 54-year-old male patient with CREST syndrome presented with colicky postprandial pain of the upper abdomen, diminished food uptake and a 6-Kg-body weight loss during the previous 2 months. An ulcerative lesion in the third portion of the duodenum was revealed during duodenoscopy, with a diagnosis of adenocarcinoma on biopsy specimen histology. The patient underwent a partial pancreatoduodenectomy. No adjuvant therapy was instituted and follow-up is negative for local recurrence or metastases 21 months postoperatively.
  
  
  CONCLUSIONS
  CREST syndrome has been associated with colon cancer, gastric polyps, familial adenomatous polyposis (FAP) syndrome and Crohn's disease; however, this is the first report of a primary adenocarcinoma of the duodenum in a patient with CREST syndrome. However, any etiologic relationship remains to be further investigated.
authors.affiliation: Second Department of Surgery, Areteion University Hospital, Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Anastasopoulos
authors.forename: Athanasios
authors.initials: A
authors.lastname: Marinis
authors.forename: Christos
authors.initials: C
authors.lastname: Konstantinidis
authors.forename: Theodosios
authors.initials: T
authors.lastname: Theodosopoulos
authors.forename: Georgios
authors.initials: G
authors.lastname: Fragulidis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Vassiliou
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000601:surgery; D017675:CREST Syndrome / Q000150:complications*; D004379:Duodenal Neoplasms / Q000150:complications* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy