2006 Volume 48 Issue 11 Pages 2632-2638
The patient is detected in a 53-year-old male. Endoscopic examination revealed two superficial cancers ; a type of flat elevation with central depression (the main lesion) and type IIa in the duodenal bulb. Duodenal X ray examination revealed one more lesion of type ha. Endoscopic ultrasonogram suggested that the main lesion invaded the muscularis propria (MP) and two ha lesions were localized in the mucosal layer (M). Pancreaticoduodenectomy was performed. Three lesions were found discontinuously. Histological examination of the resected specimen showed the main lesion to be papillary adenocarcinoma (mp, ly0, v0) and two ha lesions to be both well differentiated adenocarcinomas (m, ly0, v0). Immunohistochemical examination of human gastric mucins (HGM, MUC6, and MUC2) were performed. The main lesion was HGM (+), MUC6 (+), MUC2 (+). Two ha lesions were (+, +, -), (+, -, +), respectively. We herein reported a very rare case of primary duodenal tripple adenocar-cinomas which occurred simultaneously.
