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十二指肠原发性腺鳞癌:一例报告并文献复习

Primary adenosquamous carcinoma of the duodenum: A case report with literature review.

作者信息

Zhang He-Wei, Song Hong-Liang, Yu Hai-Bo, Ma Zhong-Wu

机构信息

Department of Hepatobiliary and Pancreatic Surgery, The Dingli Clinical Institute of Wenzhou Medical University (Wenzhou Central Hospital), Wenzhou, Zhejiang 325000, P.R. China.

出版信息

Oncol Lett. 2024 Oct 21;29(1):16. doi: 10.3892/ol.2024.14762. eCollection 2025 Jan.

Abstract

Adenosquamous carcinoma (ASC) of the duodenum is a malignant tumor that combines adenocarcinoma and squamous cell carcinoma components. Case reports of ASC are rare, and our understanding of the complex clinicopathological features and treatment strategies for the disease remains incomplete. The current study presents a case of duodenal ASC and discusses the available literature on this rare condition. A 55-year-old male patient presented with a history of jaundice and fever, with pruritus and clay-colored stools. Preoperative investigations suggested an increase in transaminase, bilirubin and tumor markers. Enhanced magnetic resonance imaging of the abdomen revealed a mass in the descending duodenum and another in the pancreatic region, without distant metastases. An endoscopy of the upper gastrointestinal tract revealed an infiltrative growth mass invading the duodenal papilla in the descending part of the duodenum. The patient underwent a Whipple procedure. Histopathological and immunohistochemical examinations confirmed duodenal ASC. Although an R0 resection was performed, the patient developed hepatic metastases 2 months after surgery and succumbed 6 months post-surgery. This case underscores the aggressive nature of duodenal ASC and the need for further studies to develop effective treatment interventions.

摘要

十二指肠腺鳞癌(ASC)是一种兼具腺癌和鳞状细胞癌成分的恶性肿瘤。ASC的病例报告罕见,我们对该疾病复杂的临床病理特征及治疗策略的认识仍不完整。本研究报告了一例十二指肠ASC病例,并讨论了关于这种罕见疾病的现有文献。一名55岁男性患者有黄疸和发热病史,伴有瘙痒和陶土样大便。术前检查提示转氨酶、胆红素及肿瘤标志物升高。腹部增强磁共振成像显示十二指肠降部有一肿块,胰腺区域还有一个肿块,无远处转移。上消化道内镜检查发现十二指肠降部有一浸润性生长肿块侵犯十二指肠乳头。患者接受了胰十二指肠切除术。组织病理学和免疫组化检查确诊为十二指肠ASC。尽管进行了R0切除,但患者术后2个月出现肝转移,术后6个月死亡。该病例强调了十二指肠ASC的侵袭性,以及开展进一步研究以制定有效治疗干预措施的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9bd/11526255/bc3a4cb23211/ol-29-01-14762-g00.jpg

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