Open AccessAdenocarcinoma of the third duodenal portion: Case report and review of literature
Author(s) -
Federico Sista,
Giuseppe De Santis,
Antonio Giuliani,
Emanuela Marina Cecilia,
Federica Piccione,
Laura Lancione,
S Leardi,
Gianfranco Amicucci
Publication year - 2012
Publication title -
world journal of gastrointestinal surgery
Language(s) - English
Resource type - Journals
ISSN - 1948-9366
DOI - 10.4240/wjgs.v4.i1.23
Subject(s) - medicine , duodenum , adenocarcinoma , duodenal cancer , surgery , lymph , endoscopy , biopsy , pancreatectomy , incidence (geometry) , general surgery , radiology , resection , cancer , pathology , physics , optics
We focus on the diagnostic and therapeutic problems of duodenal adenocarcinoma, reporting a case and reviewing the literature. A 65-year old man with adenocarcinoma in the third duodenal portion was successfully treated with a segmental resection of the third part of the duodenum, avoiding a duodeno-cephalo-pancreatectomy. This tumor is very rare and frequently affects the III and IV duodenal portion. A precocious diagnosis and the exact localization of this neoplasia are crucial factors in order to decide the surgical strategy. Given a non-specificity of symptoms, endoscopy with biopsy is the diagnostic gold standard. Duodeno-cephalo-pancreatectomy (DCP) and segmental resection of the duodenum (SRD) are the two surgical options, with overlapping morbidity (27% vs 18%) and post operative mortality (3% vs 1%). The average incidence of postoperative long-term survival is 100%, 73.3% and 31.6% of cases after 1, 3 and 5 years from surgery, respectively. Long-term survival is made worse by two factors: the presence of metastatic lymph nodes and tumor localization in the proximal duodenum. The two surgical options are radical: DCP should be used only for proximal localizations while SRD should be chosen for distal localizations.