Moderately differentiated adenocarcinoma of the third duodenal portion

Jiménez-Fuertes, Montiel; Ruíz-Tóvar, Jaime; Díaz-García, Gustavo; Durán-Poveda, Manuel

doi:10.1016/j.circen.2016.12.007

Cited by 2 publications

(8 citation statements)

References 9 publications

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“…10 As often occurs with nonspecific symptoms, her diagnosis of cancer was incidental. 4,5,8 She had first abdominal studies revealing a polypoid duodenal lesion measuring 30-40 mm, and the endoscopic biopsy was negative for malignancy. However, a major finding was the presence of high-grade epithelial dysplasia (intense atypia).…”

Section: Discussionmentioning

confidence: 99%

“…7 Worthy of note in the present case study was the incidental diagnosis of the typical ST manifested by a hiatus hernia, gallbladder disorder, and colonic diverticula. [12][13][14] According to the literature, this report involves the unsuspected, underreported, or very infrequent association of the intramucosal duodenal adenocarcinoma with the ST. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Personal (duodenal polypoid lesion) and family (uncle with intestinal cancer) antecedents may have a role in the origin of the duodenal malignancy herein described. Nevertheless, there were no consistent findings to confirm the diagnostic hypothesis either of hereditary nonpolyposis colorectal cancer or familial adenomatous polyposis.…”

Section: Discussionmentioning

confidence: 99%

“…Similar to previous descriptions, the histopathological pattern revealed by the initial endoscopic biopsy specimens established a benign duodenal polyp diagnosis. 1,4,6 Therefore, a significant concern in this setting is related to the possibility of pitfalls that may propitiate diagnostic mistakes and late evidence of an associated adenocarcinoma. Diagnosis of the tumor in the early stage, as found in the present case, allows less invasive surgical procedures, including endoscopic mucosal or submucosal interventions.…”

Section: Discussionmentioning

confidence: 99%

“…Duodenal adenocarcinomas are rare, represent 0.3% of gastrointestinal and 33-45% of the small bowel tumors, and with nonspecific symptoms, the diagnosis is incidental. [1][2][3][4][5][6][7][8][9][10] They are prevalent in the second duodenal portion of people between 40 and 60 years. 10 Risk factors include alcohol, smoked or salt-cured foods, red meats, refined sugars, hereditary nonpolyposis colorectal cancer, and familial adenomatous polyposis.…”

Section: Introductionmentioning

confidence: 99%

“…1,[6][7][8][9] Endoscopy and imaging studies may detect the intraluminal polypoid changes. 1,4,[6][7][8][9] Minimally invasive (endoscopic mucosal resection or submucosal dissection) for the superficial and complete resection for locally advanced tumors are surgical options. 10,11 Adjuvant or neoadjuvant chemotherapy are tools for patients considered inoperable.…”

Section: Introductionmentioning

confidence: 99%

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Intramucosal duodenal adenocarcinoma concomitant with Saint’s triad

et al. 2021

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Duodenal tubulovillous adenomas are rare and have malignant potential. Their successful management depends on the preoperative diagnosis and adequate excision. Endoscopic mucosal resection or submucosal dissection can control superficial tumors. Adenocarcinoma of the duodenum may originate in tubular or tubulovillous adenoma, and possible diagnostic challenges occur concerning the endoscopic biopsy findings. We report a 62-year-old female with chronic epigastric burning and a bolus sensation. Upper gastrointestinal endoscopy showed a non-ampullary duodenal tumor, and the biopsy study diagnosed a tubulovillous adenoma. Further mucosectomy revealed an intramucosal adenocarcinoma in a tubulovillous adenoma with a tumor-free pedicle. Besides the intestinal neoplasms, the patient had the diagnosis of classical Saint’s triad; and the manifestations were hiatus hernia, gallbladder disorder, and colonic diverticula. The objective is to report two scarcely described conditions and comment on controversial points of view about the concomitance of Saint’s triad and malignancy. Case reports can reduce late diagnosis, enhancing the suspicion index on rare diseases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intramucosal duodenal adenocarcinoma concomitant with Saint’s triad

et al. 2021

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Case Report: A case of advanced duodenal adenocarcinoma in complete remission after chemotherapy combined with targeted therapy and radiotherapy

Yang¹,

Wang²,

Liu³

et al. 2022

Front. Oncol.

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Duodenal adenocarcinoma (DA) is an extremely rare and highly aggressive malignant tumor of the digestive system. Due to the lack of specific clinical characteristics, it is easy to misdiagnosis and miss diagnosis, and the lack of specific consensus and recommendation for treatment, so it often refers to stomach cancer and colorectal cancer. Now, we report a case of a patient with advanced DA who achieved complete remission (CR) after undergoing chemoradiotherapy combined with targeted therapy. The patient was pathologically diagnosed with DA after radical surgery in October 2020, and he failed to undergo adjuvant chemotherapy on time due to the COVID-19 outbreak. The patient found multiple lymph node liver and abdominal metastases 6 months after the operation. Considering the progression of the disease, XELOX regimen (oxaliplatin + capecitabine) chemotherapy was given for 1 cycle. After 1 cycle of treatment, the tumor markers remained elevated; the carcinoembryonic antigen (CEA) was 5.03 ng/ml (0–5 ng/ml), and the carbohydrate antigen 19-9 (CA19-9) was 747.30 U/ml (0–37 U/ml). The patient also developed intolerable capecitabine-related treatment-related adverse events (TRAEs), namely, hand–foot syndrome. For the above reasons, capecitabine was replaced as S-1 at cycle 2, and the chemotherapy regimen became SOX (oxaliplatin + S-1); bevacizumab injection was also added to the SOX regimen, and it was further treated regularly for 7 cycles with the regimen of SOX plus bevacizumab. Liver metastases showed a continuous narrowing trend throughout the treatment period; tumor markers also showed a downward trend. Finally, the patient achieved complete remission (CR) at cycle 7. After completion of chemotherapy, radiotherapy was administered to the resistant metastatic lymph nodes present in the patient’s abdominal cavity for a total of 10 times. However, the patient developed severe bone marrow suppression and obstructive jaundice during the course of radiotherapy and finally failed to complete the radiotherapy plan. Currently, the patient continued maintenance therapy with bevacizumab and S-1 and showed no recurrence or metastasis after review. In this case of advanced DA, we referred to both CRC and gastric cancer in the treatment regimen of the patient. At the same time, targeted drugs and radiotherapy were also added to the basis of chemotherapy, which has no clear consensus recommendation or case for reference in the treatment of advanced DA. Thankfully, the patient’s disease was controlled and remained stable after treatment with this regimen. Therefore, for patients with advanced DA who lack standardized treatment regimens and guidelines, the combination of chemotherapy with targeted therapy and radiotherapy may be one of the effective treatment modalities.

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Moderately differentiated adenocarcinoma of the third duodenal portion

Cited by 2 publications

References 9 publications

Intramucosal duodenal adenocarcinoma concomitant with Saint’s triad

Intramucosal duodenal adenocarcinoma concomitant with Saint’s triad

Case Report: A case of advanced duodenal adenocarcinoma in complete remission after chemotherapy combined with targeted therapy and radiotherapy

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