Abstract
A 27-year-old man was admitted to our hospital with jaundice. Laboratory examination showed liver dysfunction and elevation of serum direct bilirubin. Enhanced abdominal computed tomography demonstrated a mass causing complete stenosis at the lower portion of the common bile duct. When ERCP was performed, the mass protruded into the lumen with an ulcer in the duodenal papilla. Endoscopic biopsy showed well differentiated tubular adenocarcinoma. A pancreatoduodenectomy was performed. Metastases of lymph nodes along the superior mesenteric artery and the proximal splenic artery were found 10 months after surgery. Several chemotherapy and radiation therapy was done. In those therapies, S-1 plus oxaliplatin and radiation therapy were effective, but the patient died 40 months after surgery. Cases in their twenties as our patient are very rare. This case suggested that multidisciplinary treatment including chemotherapy and radiation is effective at least short-term for patients with cancer of the duodenal papilla.
