Abstract
Primary duodenal carcinomas are rare and have been reported to account for less than 0.4% of all gastrointestinal carcinomas. We made a clinicopathological study of ten cases of primary duodenal carcinoma resected in our department in a recent 6-year period. These tumors appeared in the first portion in two cases and in the second portion of the duodenum in the remaining eight cases. Five patients presented with epigastralgia and four patients with icterus. At surgery, macroscopic curative resection was possible in all cases by performing pancreaticoduodenectomy. The most common gross type was type 2, in seven cases. Histologically there were five poorly differentiated adenocarcinomas and four differentiated adenocarcinomas. Tumor invasion into the pancreas was noted in eight cases, and each one case showed depth of invasion of ss and m, respectively. Positive lymph nodes were identified in seven cases. Four patients who had tumor invasion into the pancreas and severe lymph node metastasis died within 3 years, suggesting a tendency that the disease carries a poor prognosis. However, extended lymph node dissection for patients who did not have pancreatic involvement but showed positive lymph nodes provided a relatively long-term survival for them.
We consider that our selection of appropriate operative procedures including extended lymph node dissection according to the location and progress of the tumor might contribute to improved therapeutic outcomes.
