A CASE OF METASTATIC DUODENAL CANCER FOUND 6 YEARS AFTER AN OPERATION FOR UTERINE CANCER

Abstract

A 57-year-old woman with stage IIb cervical cancer of the uterus underwent extended hysterectomy combined with postoperative radio and chemotherapy in August, 1985. Subsequentry, she was hospitalized because of nausea and vomiting in September, 1990. A 5×7cm mass was palpable in the epiumbilical region of the abdomen. A radiographic smallbowel series demonstrated complete obstruction at the transverse part of the duode-num. Endoscopic studies showed an almost circular mass with a velvety appearance at the same site. However, it was difficult to establish a diagnosis of either primary or metastatic cancer, based on X-ray and endoscopic findings alone. Histological examination of biopsised tissues revealed a diagnosis of squamous cell carcinoma. By abdominal ultrasonography and computed tomography, the tumor was found to involve the aorta distal to the furcation of the superior mesenteric artery, although there was no evidence of a mass in the pelvic cavity. The tumor was confirmed by celiotomy. This seems to represent a rare case in which the metastatic tumor of the periaortic lymph nodes, originating from the uterine cancer, which had been surgically treated 5 years and 2 months before, caused obstruction of the transverse part of the duodenum.