Zhang Jin-Yuan, Wu Liu-Sheng, Yan Jun, Jiang Qiang, Li Xiao-Qiang
Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China.
School of Medicine, Tsinghua University, Beijing 100084, China.
World J Gastrointest Surg. 2024 Dec 27;16(12):3862-3869. doi: 10.4240/wjgs.v16.i12.3862.
Mucosal adenocarcinoma of the descending duodenum is a very rare gastrointestinal tumor. Due to its low incidence, it has rarely been the focus of clinical and pathological studies. The clinical manifestations of these tumors are usually nonspecific, and they are easily misdiagnosed or missed. Pathological diagnosis is the gold standard for diagnosis, but due to the small number of cases, the relevant pathological characteristics and diagnostic criteria are not completely clear. The purpose of this study was to deepen the understanding of the diagnosis and treatment of this disease and to provide a clinical guidance.
A 61-year-old woman who was hospitalized with recurrent abdominal pain for more than 20 days. The patient developed epigastric pain with no obvious cause more than 20 days prior, mainly left epigastric pain and middle epigastric pain, and presented persistent dull pain without nausea or vomiting, fever or chills. The patient was treated at a local hospital, gastroscopy revealed a new lesion in the circum-intestinal cavity in the descending part of the duodenum, and pathological biopsy revealed mucous adenocarcinoma in the descending part of the duodenum. Currently, for further diagnosis and treatment, the patient is admitted to our hospital for surgical treatment for "malignant tumor of the duodenum" in the outpatient department.
Mucosal adenocarcinoma of the descending duodenum has a high misdiagnosis rate and missed diagnosis rate, clinical manifestations lack specificity, and pathological diagnosis is the main basis for diagnosis.
十二指肠降部黏膜腺癌是一种非常罕见的胃肠道肿瘤。由于其发病率低,很少成为临床和病理研究的重点。这些肿瘤的临床表现通常不具有特异性,容易被误诊或漏诊。病理诊断是诊断的金标准,但由于病例数量少,相关病理特征和诊断标准尚不完全明确。本研究的目的是加深对该疾病诊断和治疗的认识,并提供临床指导。
一名61岁女性因反复腹痛20余天入院。患者20余天前无明显诱因出现上腹部疼痛,主要为左上腹和中上腹疼痛,呈持续性隐痛,无恶心、呕吐、发热或寒战。患者在当地医院接受治疗,胃镜检查发现十二指肠降部肠腔内有一新病变,病理活检显示十二指肠降部为黏液腺癌。目前,为进一步诊断和治疗,患者在门诊以“十二指肠恶性肿瘤”收入我院接受手术治疗。
十二指肠降部黏膜腺癌误诊率和漏诊率高,临床表现缺乏特异性,病理诊断是主要诊断依据。