A Case of Duodenal Cancer with Familial Adenomatous Polyposis Treated by Pancreas-sparing Duodenectomy

Masayuki Nagahashi, Yoshiaki Tsuchiya, Tatsuya Nomura, Atsushi Nashimoto, Hiroshi Yabusaki, Yasumasa Takii, Satoru Nakagawa, Otsuo Tanaka, Toshiyuki Kato* and Tamaki Ohta**

Division of Surgery, Division of Internal Medicine* and Division of Pathology**, Niigata Cancer Center Hospital

A 60-year-old man whose twin brother had been treated for familial adenomatous polyposis was diagnosed with the same disease in 1974 and underwent total colectomy with ileorectal anastomosis. Total excision of the residual rectum and ileal J-pouch anal anastomosis were done for multiple polyps in the residual rectum in 1991. He underwent distal gastrectomy due to multiple gastric cancer in 2000. Remnant gastric cancer was treated with endoscopic mucosal resection in 2002 and local surgical resection in 2006. Esophagogastroduodenoscopy showed a 0-IIa lesion near the esophagogastric junction in the stomach and multiple duodenal polyps. Neoplastic lesions of the stomach and duodenum were diagnosed as well-differentiated adenocarcinoma based on biopsy results. He underwent local surgical resection of the remnant stomach and pancreas-sparing duodenectomy in late May 2007. Well-differentiated adenocarcinoma of the stomach and mixed lesions of well-differentiated adenocarcinoma and adenoma of the duodenum were diagnosed based on pathological examination of surgical specimens. Both gastric and duodenal cancer were within the mucosa. He was discharged on postoperative day 11 without complications such as leakage of pancreatic or bile juice.

Key words
familial adenomatous polyposis, duodenal cancer, pancreas-sparing duodenectomy

Reprint requests
Masayuki Nagahashi Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences
1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510 JAPAN

Accepted
January 30, 2008

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