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[内镜下切除治疗胃化生中早期十二指肠腺癌]

[Early duodenal adenocarcinoma arising in gastric metaplasia treated by endoscopic resection].

作者信息

Friedrich-Rust M, Jaeger C, Gossner L, May A, Günter E, Stolte M, Ell C

机构信息

Department of Medicine II, HSK Wiesbaden, Teaching Hospital of the University of Mainz, Wiesbaden, Germany.

出版信息

Z Gastroenterol. 2006 Apr;44(4):323-8. doi: 10.1055/s-2006-926492.

Abstract

Early duodenal carcinoma is a rare entity. Most duodenal carcinomas are diagnosed at a more advanced stage. This report describes the case of a 59-year-old lady with an early duodenal adenocarcinoma diagnosed at check-up gastroduodenoscopy in an outpatient clinic who was referred to us for further investigation and management. The initial upper endoscopy at our department revealed a type IIa+c lesion in the proximal duodenum (10 - 12 mm diameter, flat elevated lesion with central depression). Using chromoendoscopy and magnification endoscopy the lesion could be well demarcated and neoplastic changes in the architecture of the intestinal villi could be detected. After submucosal epinephrine-saline injection, the lesion was removed by endoscopic resection without complications. Histopathological examination revealed the rare entity of an early duodenal carcinoma arising from incomplete-type gastric metaplasia in the duodenum. In summary, the presented paper describes a case of successful endoscopic treatment of an early duodenal carcinoma arising from incomplete gastric metaplasia.

摘要

早期十二指肠癌是一种罕见的疾病。大多数十二指肠癌在更晚期才被诊断出来。本报告描述了一例59岁女性患者的病例,该患者在门诊进行的胃十二指肠镜检查中被诊断为早期十二指肠腺癌,随后被转诊至我院进行进一步检查和治疗。我院最初的上消化道内镜检查显示十二指肠近端有一处IIa+c型病变(直径10 - 12毫米,扁平隆起病变伴中央凹陷)。通过色素内镜检查和放大内镜检查,病变能够被清晰界定,并且可以检测到肠绒毛结构中的肿瘤性变化。在进行黏膜下肾上腺素盐水注射后,通过内镜切除病变,未出现并发症。组织病理学检查显示,该病变为十二指肠不完全型胃化生引发的罕见早期十二指肠癌。总之,本文介绍了一例成功通过内镜治疗由不完全胃化生引发的早期十二指肠癌的病例。

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