title: SALL4 positive fetal gut-like adenocarcinoma of the duodenum.
abstract: Fetal gut-like adenocarcinoma is a rare carcinoma, previously reported in the stomach, which features clear cytoplasm cell papillotubular carcinoma and morphology similar to the fetal gut epithelium. SALL4, a novel marker for progenitor-type tumors, has shown high expression in fetal gut-like adenocarcinoma, which may represent oncofetal protein expression and fetal differentiation. Herein, we report the first case of fetal gut-like adenocarcinoma of the duodenum. An 81-year-old man was admitted on account of jaundice. A deeply ulcerating duodenal tumor formed a 4 cm periampullar mass. Pancreatoduodenectomy with lymphadenectomy was performed. Funicular and solid growth of clear cytoplasmic cells that resembled the fetal gut epithelium formed a poorly differentiated adenocarcinoma. Lymph node metastasis was present. Immunohistochemistry analysis showed diffuse nuclear positivity for SALL4. For postoperative therapy, S-1 was administered. The patient is alive with no recurrence, 83 months postoperatively. This case may contribute to further elucidate the disease entity of SALL4 positive, fetal-type carcinomas.
authors.affiliation: Department of Surgery, Nara Medical University, Kashihara, Nara, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Kinoshita
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sho
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Enomoto
authors.forename: Fumikazu
authors.initials: F
authors.lastname: Koyama
authors.forename: Takahiro
authors.initials: T
authors.lastname: Akahori
authors.forename: Minako
authors.initials: M
authors.lastname: Nagai
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ito
authors.forename: Kohei
authors.initials: K
authors.lastname: Morita
authors.forename: Chiho
authors.initials: C
authors.lastname: Ohbayashi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nakajima
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism*; D000369:Aged, 80 and over; D004379:Duodenal Neoplasms / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008207:Lymphatic Metastasis; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000378:metabolism* / Q000473:pathology; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000473:pathology; D014157:Transcription Factors / Q000378:metabolism*
chemical_list: C472575:SALL4 protein, human; D014157:Transcription Factors
keywords: SALL4; duodenum; fetal gut-like adenocarcinoma