PRIMARY CARCINOMA OF THE DUODENUM WITH GASTRIC SPREAD: REPORT OF ONE CASE

Abstract

In our hospital we experienced one case of primary duodenal cancer with gastric spread. A patient was 73-year-old woman, who was admitted to the hospital, since she was pointed out to have polypoid lesion in the duodenal cap by a routine gastrointestinal examination. Duodenofiberscopy showed multiple whitish polypoid lesion. Biopsy speci men showed adenocarcinoma. Gastrectomy, partial duodenectomy and lymph node dissection were performed. Gross examination revealed aggregated ha like polypoid lesion, measuring 50?70 mm in diameter, in the duodenal cap and adjacent stomach. Histologicalexamination of the resected specimen exhibited tubular adenocarcinoma with occasional villous structure. Most of the tumor cells were limited within the mucosal layer, however they invaded into the proper muscular layer in the area adjacent to the pyloric ring and involved gastric mucosa. This case suggested that the pyloric ring is a pyloro-duodenal barrier. An ultrastructual study demonstrated that this tumor was intestinal-type car cinoma. The present case is the first case of duodenal cancer in Japan examined submicroscopically by freshly fixed specimens fer electron microscopy.