A Case of Early Duodenal Bulb Carcinoma

Abstract

We reported a rare case of early duodenal bulb cancer which occurred in the pyloric ring vicinity. The patient was a 77-year-old man with upper abdominal distention after meals as the chief complaint. We performed an upper gastrointestinal endoscopy, an upper gastrointestinal series and an enhanced abdominal CT examination. These examinations revealed an approximately 3cm mass lesion in the duodenal bulb. Although endoscopic biopsy revealed Group 3, it was difficult to resect the mass lesion by endoscopic therapy. Furthermore, the mass lesion had malignant possibilities, we decided to perform surgery. Because we confirmed the mobile mass lesion in the duodenal bulb during operation, we performed a necessary distal gastrectomy. However, we were not able to confirm the swelling of neighboring lymph nodes. Macroscopically, the tumor was 1.5cm in stalk and was 2.0×2.0×1.0cm in size, at the duodenal bulb. Microscopic diagnosis was well differentiated tubular adenocarcinoma of the duodenum, limited with in mucosal layer.