Department of Surgery, Municipal Hospital of Yamaga, 511 Yamaga, Yamaga, Kumamoto, 861-0593, Japan.
Surg Today. 2011 Apr;41(4):568-71. doi: 10.1007/s00595-010-4314-0. Epub 2011 Mar 23.
We report a case of adenocarcinoma of the minor duodenal papilla, a rare type of duodenal neoplasm. A 76-year-old man with a history of surgery for rectal cancer and gastric cancer was referred to us after a follow-up upper gastrointestinal endoscopy revealed an abnormal elevation in the minor duodenal papilla. The pathological diagnosis of a biopsy specimen was adenocarcinoma. Preoperative examination of other organs revealed a tumor in the ascending colon, which was also identified as adenocarcinoma. We performed synchronous pancreatoduodenectomy and ileocecal resection with lymph node dissection. Histopathological examination of the resected specimen revealed that the papilla tumor arose from the duodenal mucosa and infiltrated the submucosa of the duodenal wall, but not the pancreatic parenchyma. Based on these findings, we diagnosed primary adenocarcinoma of the minor duodenal papilla. To our knowledge, this is only the sixth such case reported in the English-language literature, and we review all six cases after this case report.
我们报告一例十二指肠小乳头腺癌,这是一种罕见的十二指肠肿瘤。一位 76 岁男性,因直肠癌和胃癌手术史,在上消化道内镜随访时发现十二指肠小乳头异常隆起而被转来我院。活检标本的病理诊断为腺癌。其他器官的术前检查发现升结肠癌,也被诊断为腺癌。我们进行了同步胰十二指肠切除术和回盲部切除术及淋巴结清扫术。切除标本的组织病理学检查显示,乳头肿瘤起源于十二指肠黏膜并浸润十二指肠壁的黏膜下层,但未累及胰腺实质。基于这些发现,我们诊断为原发性十二指肠小乳头腺癌。据我们所知,这在英文文献中仅为第六例报道,在本病例报告后,我们对所有六例病例进行了复习。