A Case of Primary Duodenal Cancer with Psammoma Bodies

Toshio Nishikawa, Fumiyuki Inoue, Yasunori Ishii, Masahiko Takahashi¹⁾, Masanobu Mori²⁾ and Makoto Motoi³⁾

Inoue Kurinikku
Department of Surgery, Fukuyama Medical Center¹⁾
Department of Surgery, Okayama Municipal Hospital²⁾
Department of Clinical Pathology, Fukuyama Medical Association³⁾

A 75-year-old woman reporting abdominal fullness from the beginning of February 2008 was found in blood tests to have elevated CEA. Abdominal computed tomography (CT) showed pylorus ring wall thickening with calcification and lymph node swelling. Gastrointestinal endoscopy showed pyloric stenosis but did not confirm any ulcer or tumor. Biopsy of the narrow segment did not indicate malignancy. FDG-PET showed abnormal uptake in the thickened wall and lymph node confirmed by CT. Based on a diagnosis of pyloric stenosis due to gastric or duodenal malignancy indicated by elevated tumor markers and image findings, we conducted surgery, finding a mass on the anal side of the pylorus ring, necessitating distal gastrectomy and D3 lymph node ressection and Roux-en-Y reconstruction. Pathological findings showed moderately differentiated adenocarcinoma with psammoma bodies in the mass, definitively diagnosed as duodenal cancer.

Key words
primary duodenal cancer, psammoma bodies

Reprint requests
Toshio Nishikawa Inoue clinic
3-23-46 Higashifukatsu-cho, Fukuyama, 721-0974 JAPAN

Accepted
July 23, 2008

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