A CASE OF MULTIPLE ADENOCARCINOMA OF THE DUODENUM TO GROW UP TYPE

Abstract

Primary carcinomas of the duodenum excluding duodenal papilla are uncommon, especially double or multiple cancer.
This paper describes a case of primary multiple carcinoma of the duodenal supra-papillary portion, with a review of 115 cases seen in the Japanese literature from 1985 to 1990.
A 68-year-old woman was admitted because of upper abdominal discomfort and anorexia. Upper gastrointestinal series and gastrofluoroscopy revealed an irregular and elevated lesion with ulcer in the supra-papillary of the duodenum. The biopsy specimens showed adenocarcinoma. Pancreatico-duodenectomy and lymph node dissection were performed. Macroscopic findings of the resected specimen showed two separate lesions in the posterior wall of the supra-papillary duodenal portion, namely, a type IIa tumor (sm) mesurring 1.0×1.1 cm in size, and a Borrmann type 2 advanced tumor (pm) mesurring 3.7×2.2 cm in size with napking-ring stricture. Histological examination revealed that both tumors were papillotubular adenocarcinoma without lymph node metastasis and located separately. No adenoma elements were formed in and near the lesions.