Early Duodenal Cancer at the Second Portion of the Duodenum : A Case Report

Abstract

Duodenal cancers are relatively rare, especially early duodenal cancers, but we recently experienced the following case of early duodenal cancer.
A 69-year-old man was admitted to our institution for further evaluation of the duodenal lesion. Panendoscopy revealed a polypoid lesion at the second portion of the duodenum. Its pathological evaluation disclosed adenoma with severe atypical epithelium. Hypotonic duodenography showed the polypoid lesion with irregular surface, 27×20 mm in size, at middle of the second portion of the duodenum. Angiography did not reveal tumor staining or hypovascular lesion. Distant metastasis was not detected by abdominal ultrasonography and CT scan.
Cancer of the papilla Vater was highly suspected, therefore the patient underwent surgical operation. It, however, disclosed the polypoid lesion with a wide stalk at 2 or 3 cm above the papilla Vater, so polypectomy was performed instead of duodenectomy. The resected specimen was 20×18×15 mm and early duodenal cancer in adenoma was detected by its histological examination (m, ly₀, v₀) .