Objective: Cancers of the small intestine are rare pathologies. They occur with vague and unspecific symptoms and causemany problems in differential diagnosis.Methods: A 64-years-old man, smoker, suffered inappetence, nausea and vomit over about 20 days until the presence ofmelena led to his admission to our hospital. His history included diabetes mellitus and moderate alcohol intake. The objectiveexamination showed a hard-inelastic swelling in epi-mesogastric region. Laboratory data showed an increase of leukocytesand elevated level of CA 19-9. Esophagogastroduodenoscopy showed a duodenal vegetans neoformation, subjected toexamination biopsy and bacterial culture. Computed tomography scans showed a voluminous duodenal mass without safeplans of cleavage with the head of the pancreas. The biopsy results were not decisive for the presence of necrotic tissue. Themicrobiological culture was positive for Candida Glabrata mimicking an advanced mycotic abscess. Laparotomy revealed apalpable hard mass in duodenum. Cephalic duodenopancreatectomy was performed.Results: Postoperative period was regular. The patient resume eating during the sixth postoperative day and was discharged ingood conditions. The final histological diagnosis was papillary moderately differentiated adenocarcinoma with expansivegrowth in duodenal wall. There was no lymph node involvement or distant organ metastasis.Conclusions: The duodenal tumors are rare pathologies. There is association with familial adenomatous polyposis, Cronhdisease, alcohol abuse, smoking, peptic ulcer. Diagnosis is based on endoscopic and imaging techniques. The mainprognostic factors are tumor stage, lymph node involvement and metastasis. When is possible we perform a radical approachreserving palliative treatment for advanced neoplasm.
|Numero di pagine||1|
|Stato di pubblicazione||Published - 2013|
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