A Case of Curatively Resected Duodenal Cancer of the Fourth Portion

Shuji Saito, Itaru Endo, Takafumi Kumamoto, Masaru Miura, Mitsutaka Sugita, Yasuhiko Miura, Kuniya Tanaka, Shinji Togo, Hiroshi Shimada and Keiichiro Suzuki^*

The Second Department of Surgery, Yokohama City University School of Medicine Kaminagaya-chuou Clinic^*

A 54-year-old man admitted due to anemia was found in an upper gastrointestinal series to have stenosis and a diverticulum of the fourth portion of the duodenum. Endoscopy revealed a type 2 tumor with stenosis, leading to a diagnosis of well differentiated adenocarcinoma after biopsy. We segmentally resected the duodenum and dissected the lymph nodes. The dissected nodes were periduodenal, jejunal mesentery, along superior mesenteric vessels, and paraaortic. Histological findings of the tumor showed moderately differentiated tubular adenocarcinoma, with tumor cells invading through the muscularis propria to periduodenal fat tissue. Two positive nodes were periduodenal of the 65 dissected. Postoperaive diagnosis was primary adenocarcinoma of the fourth portion of the duodenum, T3 N1 M0 Stage III.
Primary duodenal adenocarcinoma, especially of the fourth portion of the duodenum, is extremely rare and advanced cancer of the third or fourth portion of the duodenum must be treated carefully with lymph node dissection.

Key words
adenocarcinoma of the fourth portion of the duodenum, segmental resection, lymph nodes dissection

Reprint requests
Shuji Saito The Second Department of Surgery, Yokohama City University School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama City, 236-0004 JAPAN

Accepted
January 31, 2001

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