A CASE OF GASTRIC TYPE DUODENAL ADENOCARCINOMA WHICHLOOKED LIKE A SUBMUCOSAL TUMOR (SMT)

Abstract

A 83-year-old man was diagnosed as having a duodenal SMT-like tumor with an opening pit via an esophagogastroduodenoscopy (EGD), and the size of the tumor increased over two months. He was referred to our hospital for further examination. The tumor was located on the superior duodenal angle (SDA) of the duodenal bulb, and had a depression on its anal side. Biopsy specimens showed well differentiated adenocarcinoma. The tumor was diagnosed as advanced carcinoma with duodenography and endoscopic ultrasonography therefore we selected a partial distal gastrectomy and partial duodenectomy as the surgical approach. Histological findings of the resected specimen revealed well differentiated tubular adenocarcinoma, which had invaded the subserosa and lymphatic vessels. Immunohistochemical staining indicated that gastric mucin such as MUC5AC and MUC6 were both positive, and that intestinal mucin such as MUC2 and CD10 were both negative, so this duodenal tumor was the completely gastric type of carcinoma.