Abstract
A 73-year-old man was admitted to the hospital because of melena. Radiographic and endoscopic examinations of the upper gastrointestinal tract showed a polypoid lesion of the duodenal bulb and cholecystlithiasis. Endoscopic biopsy of the duodenal polypoid lesion gave a histological diagnosis of group IV. Endoscopic excision was thought to be difficult, and a distal gastrectomy with a partial resection of the duodenum and a cholecystectomy was performed. Histological examination revealed tubular adenocarcinoma localized within the mucosal layer of tubular adenoma.
We reviewed 19 cases of cancer in adenoma of the duodenal bulb in the Japanese literature.
Most cases of them had adenocarcinoma localized within the mucosal layer as carcinoma in adenoma. No lymph node metastasis was reported in these cases.
As the definite diagnosis of cancer in adenoma of the doudenal bulb is not necessarily made by endoscopic biopsy preoperatively, endoscopic polypectomy or surgical polypectomy would be needed for duodenal polypoid lesions.
