Adenocarcinoma of the third duodenal portion: Case report and review of literature.

World Journal of Gastrointestinal Surgery
Federico SistaGianfranco Amicucci

Abstract

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.

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Citations

Jan 16, 2016·Cirugia y cirujanos·Montiel Jiménez-FuertesManuel Durán-Poveda
May 28, 2013·International Journal of Surgery Case Reports·Toru NakanoNoriaki Ohuchi
Jan 18, 2015·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·D DorcarattoE Hoti
May 23, 2014·Proceedings. Biological Sciences·Haoues AloutAnna Cohuet
Sep 30, 2019·Cirugía española·Josefina López-DomínguezJuan Fabregat

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