Department of Colorectal and Anal Surgery, the Second Hospital of Jilin University, Changchun.
Department of Emergency Surgery, Jilin Province People's Hospital, Changchun.
Medicine (Baltimore). 2021 Jan 22;100(3):e24378. doi: 10.1097/MD.0000000000024378.
Primary periampullary duodenal cancer accounts for 3% to 17% of periampullary cancers. There are no previous reports of metachronous primary colon and periampullary duodenal cancer.
We present a case of primary periampullary duodenal cancer that occurred metachronously after colon cancer.
Imaging and endoscopic examinations, serum tumor marker levels, and pathology confirmed metachronous colon and periampullary duodenal cancer, with 14-month interval between the diagnoses of the 2 malignancies.
The patient received right hemicolectomy combined with mFOLFOX6 chemotherapy for colon cancer and pancreatoduodenectomy for periampullary duodenal cancer.
The patient has been followed up for 6 years since the pancreatoduodenectomy and shows no signs of recurrence or metastasis.
The risk of developing a second malignancy may be associated with the site of the first tumor. Patients with right colon cancer may have particularly high risk of developing small intestinal cancer, including duodenal cancer. Early detection and active surgical treatments can improve prognosis. Long-term regular follow-up is necessary to detect new malignancies occurring after the diagnosis colon cancer.
原发性十二指肠壶腹周围癌占壶腹周围癌的 3%至 17%。此前尚无关于同时性原发性结肠癌和十二指肠壶腹周围癌的报道。
我们报告了一例结肠癌后发生的原发性十二指肠壶腹周围癌的病例。
影像学和内镜检查、血清肿瘤标志物水平和病理学检查均证实为同时性结肠癌和十二指肠壶腹周围癌,两次恶性肿瘤的诊断间隔为 14 个月。
患者接受了右半结肠切除术联合 mFOLFOX6 化疗治疗结肠癌,以及胰十二指肠切除术治疗十二指肠壶腹周围癌。
患者自胰十二指肠切除术以来已随访 6 年,未见复发或转移迹象。
发生第二恶性肿瘤的风险可能与第一个肿瘤的部位有关。右半结肠癌患者发生小肠癌(包括十二指肠癌)的风险可能特别高。早期发现和积极的手术治疗可以改善预后。诊断结肠癌后,需要进行长期定期随访以检测新发生的恶性肿瘤。