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Korean J Helicobacter  Up Gastrointest Res > Volume 13(4); 2013 > Article
The Korean Journal of Helicobacter  and Upper Gastrointestinal Research 2013;13(4):263-266.
DOI: https://doi.org/10.7704/kjhugr.2013.13.4.263    Published online December 10, 2013.
Primary Adenocarcinoma of Duodenum Located in Third Portion Cured by Wedge Resection
Chang Seok Bang, Jai Hoon Yoon, Sang Hyun Choi, Jeong Ho Eom, Yong Seop Lee, Yun Hyeong Lee, Sang Hak Han
1Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea. dryoonjh@hanmail.net
2Department of Pathology, Hallym University College of Medicine, Chuncheon, Korea.
Abstract
Primary adenocarcinoma of duodenum is an uncommon neoplasm. Besides its rarity, vague symptoms and signs with the lack of physical findings can delay diagnosis and result in poor treatment outcome. Aggressive surgical managements including pancreaticoduodenectomy was generally recommended for localized cancers despite high operational mortality. However, if early stage cancer is detected, wedge resection can be a therapeutic option. The authors encountered a 2.5x1.5 cm sized subepithelial tumor like mass with spontaneous bleeding and central dimpling located in the third portion of duodenum on esophagogastroduodenoscopy. After repeated deep biopsy, the patient underwent wedge resection and regional lymph node dissection of the duodenum. Finally, the mass was proven as adenocarcinoma and the patient remains in good condition without recurrence for over 2 years. Due to it's low incidence and high mortality, meticulous endoscopic examination of duodenum is essential for early diagnosis and limited operational methods may improve survival and quality of life of patients.
Key Words: Duodenal neoplasms; Adenocarcinoma; Pancreaticoduodenectomy
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