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Journal of Medical Ultrasonics (2001) Jan 2018Adenocarcinoma arising from the duodenum is relatively rare. Diagnosis of this disease at an early stage is difficult because its symptoms are usually nonspecific. We...
Adenocarcinoma arising from the duodenum is relatively rare. Diagnosis of this disease at an early stage is difficult because its symptoms are usually nonspecific. We herein present a case in which duodenal adenocarcinoma was successfully found by transabdominal ultrasonography. Under ultrasonography, the tumor was located in the proximal duodenum apart from the papilla of Vater, and the serosa was intact. Other diagnostic modalities showed no evidence of adjacent organ invasion or distant metastasis. Therefore, pancreatoduodenectomy was performed and the postoperative course was uneventful. The ultrasonographic findings corresponded well with the pathological diagnosis. The following three procedures were essential in this case: systematic scanning of the digestive tract to determine the location of the lesion, graded compression ultrasound to remove air bubbles from the region of interest, and precise observation of the intestinal walls using proper transducers. The precise and skillful performance of transabdominal ultrasonography using a suitable device can help to diagnose duodenal adenocarcinoma, a rare malignancy.
Topics: Adenocarcinoma; Duodenal Neoplasms; Duodenum; Female; Humans; Middle Aged; Pancreaticoduodenectomy; Tomography, X-Ray Computed; Ultrasonography
PubMed: 28439673
DOI: 10.1007/s10396-017-0785-6 -
Chemotherapy 2017Duodenal bulb adenocarcinoma is an extremely rare malignancy in the alimentary tract which has a low incidence rate and nonspecific symptoms. It is difficult to diagnose...
Duodenal bulb adenocarcinoma is an extremely rare malignancy in the alimentary tract which has a low incidence rate and nonspecific symptoms. It is difficult to diagnose early, and the misdiagnosis rate is high. CT, MRI, upper gastrointestinal endoscopy, and other advanced imaging modalities should be combined to make a comprehensive evaluation. The diagnostic confirmation of this tumor type mainly depends on the pathological examination. The combination of surgery with other treatment modalities is effective. A review of reports on duodenal bulb adenocarcinoma with chemotherapy revealed 6 cases since 1990. However, there are few reports on neoadjuvant chemotherapy for the disease. In this report, preoperative S-1 in combination with oxaliplatin neoadjuvant chemotherapy achieved a complete pathological response in the treatment of duodenal bulb adenocarcinoma. Neoadjuvant chemotherapy shows a better clinical efficacy in the treatment of duodenal bulb adenocarcinoma, but its value needs to be further verified.
Topics: Adenocarcinoma; Duodenal Neoplasms; Duodenum; Endoscopy, Gastrointestinal; Humans; Male; Middle Aged; Neoadjuvant Therapy; Organoplatinum Compounds; Oxaliplatin; Tomography, X-Ray Computed
PubMed: 28490007
DOI: 10.1159/000469700 -
Gastrointestinal Endoscopy Mar 2024
Topics: Humans; Duodenum; Duodenal Neoplasms; Adenocarcinoma; Retrospective Studies; Treatment Outcome; Endoscopic Mucosal Resection
PubMed: 37804876
DOI: 10.1016/j.gie.2023.10.004 -
The American Surgeon Feb 2021Duodenal adenocarcinoma treatment consists of either simple or radical surgical resection. Existing evidence suggests similar survival outcomes between the two but is... (Comparative Study)
Comparative Study
BACKGROUND
Duodenal adenocarcinoma treatment consists of either simple or radical surgical resection. Existing evidence suggests similar survival outcomes between the two but is limited by small numbers and single-institution analysis. We aim to compare survival after partial versus radical resection for duodenal adenocarcinoma using the National Cancer Database (NCDB).
METHODS
Using NCDB results from 2004 to 2014, we compared patients with duodenal adenocarcinoma undergoing partial resection (n = 1247) and radical resection (n = 1240) by age, sex, facility type, facility location, cancer stage, cancer grade, lymph node sampling, node status, tumor size, margin status, neoadjuvant therapy, and adjuvant therapy using chi-square analysis. Survival was compared using propensity matching.
RESULTS
Patients undergoing partial resection had overall earlier cancer stage, more favorable tumor grade, and were less likely to undergo lymph node sampling and neoadjuvant therapy. When overall survival was compared between the 2 propensity-matched groups, the median survival was 46.7 months after partial resection and 43.2 months after radical resection ( = .329), and overall survival was similar between the 2 groups ( = .894). The use of adjuvant therapy demonstrated improved survival over either surgery alone ( < .0001, = .0037).
CONCLUSION
Partial resection did not demonstrate worse survival outcomes than radical resection for duodenal adenocarcinoma. The use of adjuvant therapy in addition to surgery demonstrated improved survival regardless of surgery type and played a larger role in survival than the type of surgery. Our findings provide evidence to support the continued use of both partial and radical surgical resections to treat duodenal malignancy.
Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Databases, Factual; Duodenal Neoplasms; Duodenum; Female; Humans; Male; Middle Aged; Neoplasm Grading; Propensity Score; Survival Analysis; United States; Young Adult
PubMed: 32927979
DOI: 10.1177/0003134820951432 -
Asian Journal of Surgery Mar 2022
Topics: Adenocarcinoma; Ampulla of Vater; Colon, Ascending; Duodenal Neoplasms; Humans; Pancreatic Ducts
PubMed: 35058108
DOI: 10.1016/j.asjsur.2021.12.031 -
Journal of Gastrointestinal Cancer Sep 2019
Topics: Adenocarcinoma; Aged; Antineoplastic Combined Chemotherapy Protocols; Biopsy; Duodenal Neoplasms; Duodenum; Female; Humans; Neoplasms, Second Primary; Ovarian Neoplasms; Palliative Care; Pancreaticoduodenectomy; Rare Diseases; Rectal Neoplasms; Rectum
PubMed: 29392602
DOI: 10.1007/s12029-018-0066-7 -
African Journal of Paediatric Surgery :... 2014Gastrointestinal malignancies are extremely rare in the paediatric population and duodenal cancers represent an even more unusual entity. It represents 0.3-1% of all...
Gastrointestinal malignancies are extremely rare in the paediatric population and duodenal cancers represent an even more unusual entity. It represents 0.3-1% of all gastrointestinal tumours. A case report of a 10-year-old boy with duodenal adenocarcinoma is reported and the difficulties of diagnosing and treating this rare tumour are discussed.
Topics: Adenocarcinoma; Child; Diagnosis, Differential; Duodenal Neoplasms; Duodenum; Endoscopy, Digestive System; Gastroplasty; Humans; Magnetic Resonance Imaging; Male; Radiography, Abdominal; Tomography, X-Ray Computed; Vagotomy
PubMed: 24647303
DOI: 10.4103/0189-6725.129244 -
Revista Espanola de Enfermedades... Jul 2022Small bowel adenocarcinoma is a rare tumor accounting for only 0.3-0.4% of all gastrointestinal tumors, with duodenal adenocarcinoma being the most common subtype. In...
Small bowel adenocarcinoma is a rare tumor accounting for only 0.3-0.4% of all gastrointestinal tumors, with duodenal adenocarcinoma being the most common subtype. In most patients, it presents with nonspecific signs and symptoms, often leading to a delay in diagnosis. Therefore, it is essential to establish an adequate initial clinical suspicion to carry out an adequate diagnostic approach, being necessary to perform both radiological and endoscopic diagnostic techniques.
Topics: Adenocarcinoma; Duodenal Neoplasms; Duodenum; Humans; Intestine, Small
PubMed: 35240850
DOI: 10.17235/reed.2022.8732/2022 -
Digestion 2013The incidence of esophageal cancer continues to rise in the Western world. Prior studies have suggested that gastroduodenal content reflux from gastroesophageal reflux... (Review)
Review
The incidence of esophageal cancer continues to rise in the Western world. Prior studies have suggested that gastroduodenal content reflux from gastroesophageal reflux disease induces the inflammation-mediated progression from hyperplasia to metaplasia, and to adenocarcinoma. We further investigated the sequential development of esophageal adenocarcinoma (EADC) with the use of an established surgical rat model. The present paper will describe the impact of the inflammation-metaplasia-adenocarcinoma sequence and chemoprevention in surgical rat models. A clinically relevant rat reflux model was used to investigate the cause of carcinogenesis, the sequential development of adenocarcinoma and chemoprevention with the use of a proton pump inhibitor. We found that duodenal reflux plays an important role in the inflammation-induced transformation of esophageal mucosa to adenocarcinoma. We were able to inhibit this transformation with rabeprazole, a proton pump inhibitor. Duodenal reflux promotes inflammation in the esophagus. The inflammation-metaplasia-adenocarcinoma sequence is important in the progression and development of EADC. Carcinogenesis can be prevented with chemoprevention agents such as rabeprazole. These results will need to be validated in clinical trials.
Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Adenocarcinoma; Animals; Disease Models, Animal; Disease Progression; Duodenum; Epithelium; Esophageal Neoplasms; Esophagus; Metaplasia; Proton Pump Inhibitors; Rabeprazole; Rats
PubMed: 23343962
DOI: 10.1159/000343896 -
Digestive and Liver Disease : Official... Feb 2019Lynch syndrome (LS) is associated with an increased risk of small bowel tumors but routine screening is not recommended in international guidelines. The aim of our study...
BACKGROUND AND AIMS
Lynch syndrome (LS) is associated with an increased risk of small bowel tumors but routine screening is not recommended in international guidelines. The aim of our study was to determinate the prevalence of duodenal tumors in a French cohort of LS patients.
METHODS
Patients carrying a germline pathogenic variant in a MMR gene, supported by our local network, in which at least one upper endoscopy had been performed, were included. We registered the occurrence of duodenal lesions in those patients.
RESULTS
154 LS patients were identified including respectively 85 MSH2 and 41 MLH1 mutated patients respectively. Seven out of 154 (4.5%) had at least one duodenal lesion. Median age at diagnosis was 58 years (range: 49-73). The twelve lesions locations were: descending duodenum (n = 7), genu inferius (n = 2), duodenal bulb (n = 1), ampulla (n = 1), fourth duodenum (n = 1). Three lesions were invasive adenocarcinomas. The incidence rate of duodenal lesions in patients with MSH2 or MLH1 pathogenic variants was respectively 7.1% (6 out of 85) and 2.4% (1 out of 41) emphasizing a trend toward increased risk of developing duodenal lesion in MSH2 mutated patients: OR: 5.17, IC95% (0.8-60.07), p = 0.1307.
CONCLUSION
Regarding this high prevalence rate, especially in MSH2 patients, regular duodenal screening during upper endoscopy should be considered in routine in LS patients.
Topics: Adenocarcinoma; Cohort Studies; Colorectal Neoplasms, Hereditary Nonpolyposis; DNA Repair; DNA Repair Enzymes; Duodenal Neoplasms; Duodenum; Endoscopy, Gastrointestinal; Female; France; Genetic Predisposition to Disease; Germ-Line Mutation; Humans; Male; Middle Aged; MutL Protein Homolog 1; MutS Homolog 2 Protein; Prevalence; Protein Subunits
PubMed: 30448460
DOI: 10.1016/j.dld.2018.10.005