[Moderately differentiated adenocarcinoma of the third duodenal portion]

Abstract

Background: Duodenal carcinoma is very rare. It represents 33-45% of the all tumours of the small bowel. The symptoms are non-specific, and the diagnosis is often accidental.

Clinical case: A 35-year old man was admitted to our hospital with post-prandial abdominal pain. Upper gastrointestinal examination revealed a tumour of the third duodenal portion, which was diagnosed, using endoscopic biopsy, as a tubular adenoma with high grade dysplasia. The computed axial tomography scan, the magnetic resonance imaging, and the endoscopic ultrasound showed the neoplasia of the third duodenal portion with no lymph node or peritoneal metastases. Partial resection of the duodenum was performed. The definitive histopathological diagnosis was primary adenocarcinoma of the third duodenal portion. pT2 N0M0, originated in a tubular adenoma.

Conclusions: Primitive neoplasia of the duodenum is very rare. Duodeno-cephalo-pancreatectomy is recommended in proximally located tumours, while segmental resection of the duodenum is appropriate for distal locations, with the same survival.

Keywords: Cancer; Carcinoma duodenal; Cáncer; Duodenal carcinoma; Duodeno; Duodenum; Endoscopia; Endoscopy.