title: Poorly differentiated adenocarcinoma with signet-ring cells in duodenal papilla: a case report.
abstract: An 82-year-old woman with common bile duct (CBD) dilatation observed during routine ultrasonography was referred to our hospital. Preliminary blood tests revealed elevated levels of hepatobiliary enzymes. Computed tomography (CT) scan showed lower bile duct wall thickening and enhancement. Esophagogastroduodenoscopy revealed mildly swollen papilla of Vater, without ulceration. Endoscopic retrograde cholangiography demonstrated that the CBD was grossly dilated with a constriction in the lower part. The final diagnosis indicated poorly differentiated adenocarcinoma of duodenal papilla with signet-ring cells; pT3N0M0, stage IIA (Unio Internationalis Contra Cancrum, 7th edition), for which subtotal stomach-preserving pancreaticoduodenectomy (SSPPD) was performed. This case is quite rare, and the surgery resulted in a desirable outcome. The patient has been disease-free for 5 years since the surgery.
authors.affiliation: Department of Surgery, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo, Aichi, 446-8602, Japan. medisemi@yahoo.co.jp.
authors.forename: Yuta
authors.identifier: http://orcid.org/0000-0003-3076-8013
authors.initials: Y
authors.lastname: Ushida
authors.affiliation: Department of Surgery, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo, Aichi, 446-8602, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hiramatsu
authors.affiliation: Department of Surgery, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo, Aichi, 446-8602, Japan.
authors.forename: Satomi
authors.initials: S
authors.lastname: Saeki
authors.affiliation: Department of Surgery, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo, Aichi, 446-8602, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Amemiya
authors.affiliation: Department of Surgery, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo, Aichi, 446-8602, Japan.
authors.forename: Hidenari
authors.initials: H
authors.lastname: Goto
authors.affiliation: Department of Surgery, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo, Aichi, 446-8602, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Arai
keywords: Duodenal papillary cholangiocarcinoma; Poorly differentiated adenocarcinoma; Signet-ring cell