Yanagië H, Imai H, Tani T, Ogata M
Dept. of Surgery, Fukujuji Hospital.
Gan No Rinsho. 1990 Sep;36(11):2063-6.
Reported is a case of a suprapapillary primary early duodenal cancer in a 50 year old male patient who had had a hemicolectomy 15 years earlier for a colon cancer. The patient had undergone upper gastrointestinal endoscopy during a mass screening for abnormalities in the gastro-intestinal tract, and a slightly depressed lesion of the IIa + IIc type, 25 x 20 mm in diameter, was discovered accidentally at the superior duodenal flexure. The subsequent biopsy revealed a well differentiated tubular adenocarcinoma. Thus, the patient underwent a subtotal gastrectomy and a partial duodenectomy with a lymph node dissection. The histology of the resected specimen was the same as that of the biopsy, but only the mucosa was involved. Adenomatous lesions of the colon are known to occasionally accompany upper gastro-intestinal tumor, so that periodic gastro-intestinal scrutiny follow-ups are mandatory.
报告了一例50岁男性患者的乳头上方原发性早期十二指肠癌病例，该患者15年前因结肠癌接受了半结肠切除术。患者在进行胃肠道异常的大规模筛查时接受了上消化道内镜检查，偶然在十二指肠上段发现了一个直径25×20mm的IIa + IIc型略凹陷病变。随后的活检显示为高分化管状腺癌。因此，患者接受了胃次全切除术和十二指肠部分切除术及淋巴结清扫术。切除标本的组织学与活检相同，但仅累及黏膜。已知结肠腺瘤性病变偶尔会伴有上消化道肿瘤，因此定期进行胃肠道仔细随访是必要的。
