A Case of Early Duodenal Cancer, Similar to Nodule-aggregating Lesions

Hisashi Imai¹⁾, Katsuyuki Kunieda¹⁾, Toshiya Kuno¹⁾, Yoshihiro Tanaka¹⁾, Norihiro Yasue¹⁾, Shigetoyo Saji¹⁾, Kuniyasu Shimokawa²⁾ and Hiroo Goto³⁾

Second Department of Surgery¹⁾, Department of Labolatory Medicine²⁾, Department of Radiology³⁾, Gifu University School of Medicine

A 63-year-old man was admitted to a general hospital with complaints of right hypochondralgia and vomiting. He was diagnosed as having choledocholithiasis and cholecystitis, and underwent cholecystectomy and choledocholithotomy. During admission, hypotonic duodenography and choledochography via the T-tube were performed, which revealed a spongiform tumor in the duodenum, because the increasing of from T-tube. He was moved to our hospital and gastroduodenal fiberscopy and biopsy confirmed a well-differentiated adenocarcinoma of the duodenum, and pylorus-preserving pancreaticoduodenectomy (PPPD) with D1 lymphadenectomy was performed. Macroscopically, the resected specimen showed a tumor 9.0×6.0×3.0cm in size, located in the second to third portion of the duodenum, involving the papilla of Vater. The surface of the tumor had a villous and lobularated appearance. Microscopically, the tumor was localized within the mucosa (m, n0) and was diagnosed as an early papillary adenocarcinoma of the duodenum.

Key words
nodule-aggregating lesions, early duodenal cancer, pylorus preserving pancreaticoduodenectomy

Reprint requests
Hisashi Imai Second Department of Surgery, Gifu University School of Medicine 40 Tsukasamachi, Gifu, 500-8705 JAPAN

Accepted
March 28, 2001

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