Primary Advanced Adenocarcinoma of the Duodenal Bulb

Tomohiro Saito, Kiyoshi Nakamura, Yoshio Konishi, Masaru Sawataishi*, Masao Fujimaki*

Nagano Icho Hospital
*Second Department of Surgery, Toyama Medical and Pharmaceutical University

We encountered a case of advanced carcinoma of the duodenal bulb. The patient was a 68-year-old woman with epigastralgia and appetite loss as the chief complaints. An upper gastrointestinal series and endoscopic examination showed an ulcerative lesion in the anterior wall of the duodenal bulb. The biopsy specimen revealed adenocarcinoma. Under a diagnosis of advanced cancer of the duodenal bulb, subtotal gastrectomy and partial duodenectomy were performed with dissection of the regional lymph nodes. Macroscopically, the tumor had a Borrmann 2-like appearance and was 2.8×2.5 cm in size. Microscopic diagnosis was moderately differentiated tubular adenocarcinoma with invasion of the serosa. Only 26 previous cases of advanced carcinoma of the duodenal bulb have been reported in the Japanese literature, and our knowledge of its clinical features is still deficient. Forty cases of advanced duodenal carcinoma in the Japanese literature were collected and discussed.

Key words
carcinoma of duodenal bulb, advanced cancer

Reprint requests
Tomohiro Saito Second Department of Surgery, Toyama Medical and Pharmaceutical University
2630 Sugitani, Toyama, 930-01 JAPAN

Accepted
May 11, 1994

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