A CASE OF PRIMARY EARLY CARCINOMA OF THE DUODENAL BULB.

Abstract

In April 1978, a 72 year-old woman visited the Kokura Memorial Hospital complaining of a discomfort in the anterior chest after meal. Physical examination revealed no abnormalities. Roentogen examination of the upper gastrointestinal tract showed an irregular, well-defined elevated lesion in the duodenal bulb. Duodenof iberscopy revealed a nodular polypoid lesion on the posterior wall of the duodenal bulb. The surface of the lesion was not associated with any redness, bleeding, erosion or ulcer. Histological examination of the biopsy specimen showed adenocarcinoma. Surgical operation disclosed a nodular tumor with a short stalk, measuring 1.0 × 1.0cm in diameter, on the posterior wall of the duodenal bulb distal to the pyloric ring by about 2cm. Histology of the resected specimen revealed well-differentiated tubular adenocarcinoma limited within the mucosa with no lymphnode metastasis. Case reports of a primary early carcinoma of the doudenum are rare. Seven cases have been described in Japan, except for those in the papilla Vateri. Of the seven cases reported, four were in the duodenal bulb, two were suprapapillary and one was inf rapapillary. Our case appears to be the eighth case reported in Japan.