Matsuyama Sho, Fukuda Akihisa, Agatsuma Nobukazu, Hoki Masahito, Utsumi Takahiro, Seno Hiroshi
Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Japan.
Department of Diagnostic Pathology, Kyoto University Hospital, Japan.
Intern Med. 2025 Jun 1;64(11):1684-1690. doi: 10.2169/internalmedicine.4004-24. Epub 2024 Nov 8.
We herein report a rare case of duodenal adenocarcinoma with a rapidly progressive course. Esophagogastroduodenoscopy revealed Brunner's gland hyperplasia in the bulbs of the duodenum three years prior to this presentation. Two years earlier, gastric foveolar metaplasia had been observed in the bulbs. One year earlier, the lesion had increased slightly in size. At this time, the lesion had markedly increased in size, and the duodenum was circumferentially stenotic due to the mass. Pathologically, he was diagnosed with duodenal adenocarcinoma with a gastric-dominant immunophenotype and he died two months later. Although extremely rare, we should keep in mind that duodenal tumors with a gastric phenotype may sometimes progress rapidly within a short period of time.
我们在此报告一例十二指肠腺癌病例,病程进展迅速。在此次就诊三年前,食管胃十二指肠镜检查发现十二指肠球部有布伦纳腺增生。两年前,在十二指肠球部观察到胃小凹化生。一年前,病变大小略有增加。此时,病变大小显著增加,由于肿块导致十二指肠周向狭窄。病理检查诊断为具有胃主导免疫表型的十二指肠腺癌,患者两个月后死亡。尽管极为罕见,但我们应牢记,具有胃表型的十二指肠肿瘤有时可能在短时间内迅速进展。