A case of adenosquamous carcinoma of the duodenal bulb in an aged hemodialysis patient

Abstract

An 83-year-old man was found to have severe anemia during hemodialysis for chronic renal failure. An upper gastrointestinal endoscopic study showed a whole-circumferentially growing adenocarcinoma at the duodeal bulb. An abdominal CT scan showed multiple hepatic metastases and unresectable duodenal adenocarcinoma was diagnosed. However, it was difficult for the patient to be a candidate for chemotherapy due to his great age and his renal failure requiring hemodialysis. We thus performed gastrectomy with the resection of the duodenal bulb (palliative surgery). The histopathological diagnosis was adenosquamous carcinoma, in which squamous cell carcinoma had dominated the main foci. As for the patient's postoperative course, he developed jaundice due to hepatic metastasis followed by hepatic failure in an early time and died on the 23rd postoperative day.
Adenosquamous carcinoma arisen in the duodenum in the narrow sense is extremely rare and carries poor prognosis. We present here a case of adenosquamous carcinoma of the duodenal bulb in an aged hemodialysis patient whose lesion was resected, together with a review of the literature.