Yoshioka Ryo, Tomimaru Yoshito, Noguchi Kozo, Nagase Hirotsugu, Ogino Takayuki, Hirota Masashi, Oshima Kazuteru, Tanida Tsukasa, Noura Shingo, Imamura Hiroshi, Iwazawa Takashi, Akagi Kenzo, Tamura Hiromi, Adachi Shiro, Dono Keizo
Dept. of Surgery, Toyonaka Municipal Hospital.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2586-2588.
A 60s man underwent upper gastrointestinal endoscopy at a regular medical check-up without symptoms, which showed an ulcerative region in the duodenal ampulla, measuring 3 cm in diameter. He was diagnosed with poorly differentiated adenocarcinoma on biopsy and referred to our hospital. Abdominal contrast-enhanced CT scan revealed an enhanced-ulcerative tumor, measuring 3 cm, at the duodenal ampulla. After the preoperative diagnosis of adenocarcinoma of the duodenal ampulla, subtotal stomach-preserving pancreatoduodenectomy with regional lymph node dissection was performed. The final diagnosis was neuroendocrine carcinoma(NEC)of the duodenal ampulla. He has been alive for 9 years with no recurrences. NEC of the duodenal ampulla is rare, and its prognosis is poor. We report a case of long-term survival after resection of NEC of the duodenal ampulla.
一名60多岁男性在无症状的定期体检中接受了上消化道内镜检查,结果显示十二指肠壶腹有一个直径3厘米的溃疡性区域。活检诊断为低分化腺癌,遂转诊至我院。腹部增强CT扫描显示十二指肠壶腹有一个3厘米的强化溃疡性肿瘤。在术前诊断为十二指肠壶腹腺癌后,进行了保留胃的胰十二指肠次全切除术及区域淋巴结清扫术。最终诊断为十二指肠壶腹神经内分泌癌(NEC)。他已存活9年,无复发。十二指肠壶腹NEC罕见,预后较差。我们报告一例十二指肠壶腹NEC切除术后长期生存的病例。