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Case report: A case of laterally spreading duodenal cancer with slight submucosal invasion accompanied with concurrent lymph nodes metastasis

A 70‐year‐old female diagnosed with duodenal cancer was referred to our hospital. Esophagogastroduodenoscopy revealed an 80 mm flat elevated lesion was located in the inner wall of the second part of the duodenum and the lesion completely involved major papilla. Endoscopic submucosal dissection (ESD...

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Autores principales: Iwata, Kentaro, Kato, Motohiko, Nakayama, Atsushi, Kanai, Takanori, Yahagi, Naohisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9302270/
https://www.ncbi.nlm.nih.gov/pubmed/35873515
http://dx.doi.org/10.1002/deo2.100
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author Iwata, Kentaro
Kato, Motohiko
Nakayama, Atsushi
Kanai, Takanori
Yahagi, Naohisa
author_facet Iwata, Kentaro
Kato, Motohiko
Nakayama, Atsushi
Kanai, Takanori
Yahagi, Naohisa
author_sort Iwata, Kentaro
collection PubMed
description A 70‐year‐old female diagnosed with duodenal cancer was referred to our hospital. Esophagogastroduodenoscopy revealed an 80 mm flat elevated lesion was located in the inner wall of the second part of the duodenum and the lesion completely involved major papilla. Endoscopic submucosal dissection (ESD) was performed and the lesion was resected in a single piece including the part of the major papilla. The pathological examination of the resected specimen showed moderately differentiated adenocarcinoma limited in the mucosa in most parts of the lesion, however, cancer cells invaded into the submucosal layer with an invasion depth of 100 μm in only a small area. Lymph ductal involvement was confirmed in that area. Two months after ESD, pylorus‐preserving pancreatoduodenectomy combined with extended lymph node dissection was additionally performed. The postoperative pathological examination revealed lymph ductal involvement was observed in the regional lymph node. While the postoperative clinical course was uneventful, systematic metastasis was pointed out 5 months after surgery. The patient was died 9 months after surgery. Due to its rarity, the natural history of duodenal cancer has been still unclear. In this case, even a lesion with only a localized small area of submucosal invasion developed systemic metastasis, indicating the high malignant potential of duodenal cancer.
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spelling pubmed-93022702022-07-22 Case report: A case of laterally spreading duodenal cancer with slight submucosal invasion accompanied with concurrent lymph nodes metastasis Iwata, Kentaro Kato, Motohiko Nakayama, Atsushi Kanai, Takanori Yahagi, Naohisa DEN Open Case Reports A 70‐year‐old female diagnosed with duodenal cancer was referred to our hospital. Esophagogastroduodenoscopy revealed an 80 mm flat elevated lesion was located in the inner wall of the second part of the duodenum and the lesion completely involved major papilla. Endoscopic submucosal dissection (ESD) was performed and the lesion was resected in a single piece including the part of the major papilla. The pathological examination of the resected specimen showed moderately differentiated adenocarcinoma limited in the mucosa in most parts of the lesion, however, cancer cells invaded into the submucosal layer with an invasion depth of 100 μm in only a small area. Lymph ductal involvement was confirmed in that area. Two months after ESD, pylorus‐preserving pancreatoduodenectomy combined with extended lymph node dissection was additionally performed. The postoperative pathological examination revealed lymph ductal involvement was observed in the regional lymph node. While the postoperative clinical course was uneventful, systematic metastasis was pointed out 5 months after surgery. The patient was died 9 months after surgery. Due to its rarity, the natural history of duodenal cancer has been still unclear. In this case, even a lesion with only a localized small area of submucosal invasion developed systemic metastasis, indicating the high malignant potential of duodenal cancer. John Wiley and Sons Inc. 2022-02-26 /pmc/articles/PMC9302270/ /pubmed/35873515 http://dx.doi.org/10.1002/deo2.100 Text en © 2022 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Reports
Iwata, Kentaro
Kato, Motohiko
Nakayama, Atsushi
Kanai, Takanori
Yahagi, Naohisa
Case report: A case of laterally spreading duodenal cancer with slight submucosal invasion accompanied with concurrent lymph nodes metastasis
title Case report: A case of laterally spreading duodenal cancer with slight submucosal invasion accompanied with concurrent lymph nodes metastasis
title_full Case report: A case of laterally spreading duodenal cancer with slight submucosal invasion accompanied with concurrent lymph nodes metastasis
title_fullStr Case report: A case of laterally spreading duodenal cancer with slight submucosal invasion accompanied with concurrent lymph nodes metastasis
title_full_unstemmed Case report: A case of laterally spreading duodenal cancer with slight submucosal invasion accompanied with concurrent lymph nodes metastasis
title_short Case report: A case of laterally spreading duodenal cancer with slight submucosal invasion accompanied with concurrent lymph nodes metastasis
title_sort case report: a case of laterally spreading duodenal cancer with slight submucosal invasion accompanied with concurrent lymph nodes metastasis
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9302270/
https://www.ncbi.nlm.nih.gov/pubmed/35873515
http://dx.doi.org/10.1002/deo2.100
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