Department of Gastroenterology, St. Luke's International Hospital, 9-1 Akashicho, Chuo-ku, Tokyo, 104-8560, Japan.
Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba, 272-8513, Japan.
Clin J Gastroenterol. 2020 Dec;13(6):1102-1110. doi: 10.1007/s12328-020-01173-w. Epub 2020 Jul 11.
We present a case of non-ampullary duodenal signet-ring cell carcinoma treated by endoscopic mucosal resection. The patient is a 61-year-old male with a history of coronary artery bypass grafting, hypertension, dyslipidemia, and diabetes mellitus complicated by end-stage renal disease requiring peritoneal dialysis who presented for routine endoscopic screening. A 9 mm protruding mass was found in the second part of the duodenum, proximal to the ampulla of Vater. Biopsy of the mass revealed proliferation of signet-ring cells with vacuolated foamy cytoplasm and displaced ovoid nuclei, consistent with signet-ring cell carcinoma. We performed endoscopic mucosal resection and achieved margin-free resection without complications. No recurrence was seen during the 24 months of follow-up. Duodenal signet-ring cell carcinoma is a rare entity most commonly occurring in the ampulla of Vater. This is the first report of successful endoscopic mucosal resection for early non-ampullary duodenal signet-ring cell carcinoma.
我们报告一例经内镜黏膜切除术治疗的非壶腹十二指肠印戒细胞癌。患者为 61 岁男性，有冠状动脉旁路移植术、高血压、血脂异常和糖尿病病史，并发终末期肾病需要腹膜透析，来院行常规内镜筛查。于十二指肠第二段发现 1 个 9mm 的隆起性肿块，靠近 Vater 壶腹。肿块活检显示有印戒细胞增生，细胞质有空泡状泡沫，细胞核呈偏位的卵圆形，符合印戒细胞癌。我们行内镜黏膜切除术，达到无切缘的切除，无并发症。24 个月随访期间未见复发。十二指肠印戒细胞癌是一种罕见的实体瘤，最常发生在 Vater 壶腹。这是首例成功内镜黏膜切除治疗早期非壶腹十二指肠印戒细胞癌的报告。
