A Case of Superficial Widespread Tumor of the Duodenal Second Portion with Lower Rectal Carcinoma

Tomomichi Yoshikawa¹⁾²⁾, Kazuaki Sasaki¹⁾, Hajime Takasaka¹⁾, Hiroyuki Kawasaki¹⁾²⁾, Keisuke Ono¹⁾²⁾, Kei Ono¹⁾²⁾, Noriko Nishikawa¹⁾²⁾ and Koichi Hirata²⁾

¹⁾Department of Surgery, Doto Hospital
²⁾First Department of Surgery, Sapporo Medical University School of Medicine

A 69-year-old man reporting melena and difficulty in bowel evacuato was admitted under a diagnosis of rectal carcinoma. Preoperative gastroendoscopy showed a surficial widespread tumor of the duodenal second portion located on the anal side of the papilla of Vater. Endoscopic biopsy showed that the tumor was tubullo-villous adenoma with severe atypia. Endoscopic ultrasonography showed that the tumors were localized within the mucosal layer. No other tumors were seen aside from those in the rectum and duodenum. We conducted low anterior resection for rectal carcinoma, incised the duodenum, and undertook ring-shaped partial resection of the duodenum for the duodenal tumor. Histopathological examination of resected material showed the duodenal tumor to be tubullovillous adenoma with severe atypia and rectal carcinoma to be well-differentiated adenocarcinoma, depth ss, stage IIIb.

Key words
duodenum, adenoma, rectal cancer

Reprint requests
Tomomichi Yoshikawa Department of Surgery, Doto Hospital
North 17, East 14, Higashi-ku, Sapporo, 065-8555 JAPAN

Accepted
September 24, 2003

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