A Case of Early Cancer of the Fourth Portion of the Duodenum

Tetsuo Ishizaki, Makoto Takagi, Takashi Ogata, Yoshihiro Yasuda, Kazushige Itou, Ichirou Sonoda, Yoshiaki Suzuki, Tetsuo Sumi, Tatsuya Aoki* and Motohide Shimazu

Department of Digestive Tract Surgery, Hachiouji Medical Center of Tokyo Medical University
Third Department of Surgery, Tokyo Medical University*

A 72-year-old woman who underwent upper gastrointestinal endoscopy for epigastric discomfort was found to have a protruding lesion in the fourth part of the duodenum, upon admission diagnostic imaging studies showed no evidence of distant metastasis or lymph node enlargement, and tumor marker values were normal. Biopsy results indicated adenoma with moderate to severe atypia, but because of the lesion's 40 mm diameter, adenocarcinoma could not be ruled out necessitating surgery. Lymph nodes were submitted for rapid pathological diagnosis intraoperatively, and results confirmed the absence of metastasis, so we conducted a partial duodenectomy, The pathological diagnosis was very well-differentiated 40 mm×25 mm adenocarcinoma, T1N0M0 stage I. Reports of early-stage primary cancer of the fourth portion of the duodenum are very rare, and we induce a discussion of the literature.

Key words
duodenum, fourth portion of duodenum, early cancer

Reprint requests
Tetsuo Ishizaki Department of Digestive Tract Surgery, Hachiouji Medical Center of Tokyo Medical University
1163 Tatemachi, Hachiouji, 193-0998 JAPAN

Accepted
November 28, 2007

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