An unusual gastrointestinal tumor: Primary Carcinoma of the duodenum.

Konference: 2008 XXXII. Brněnské onkologické dny a XXII. Konference pro sestry a laboranty

Kategorie: Gastrointestinální nádory

Téma: XXI. Nádory žaludku a duodena

Číslo abstraktu: 185

Autoři: Ao.Univ.-Prof. Bela Teleky; Priv.-Doz. Dr. Tudor Birsan; Ao.Univ.-Prof. Johannes Zacherl

A 23-year old female patient presented with a 2-week history of epigastric pain and vomiting. Endoscopic and CT workup revealed an obstructing mass in the 3rd portion of the duodenum. She underwent surgery, with segmental resection of the duodenum and primary duodenojejunostomy. On histologic examination, the tumor was found to be an adenocarcinoma of the duodenum, G3 T3 N0 (0/12) M0 L1 V0 (UICC stage II). Adjuvant chemotherapy with capecitabin and oxaliplatin was further recommended.

Adenocarcinoma of the duodenum is a rare entity, and published series are small. Due to the paucity of symptoms, it is usual-ly discovered at an advanced stage.

In the absence of metastases, surgical resection – when feasible – is the only curative treatment. While duodenopancreatec-tomy is necessary for resection of tumors in the 1st and 2nd portions of the duodenum, segmental resection is sufficient for lesi-ons in the 3rd and 4th portion of the duodenum. Survival rates are good if there is no residual tumor after surgery. Absence of tumor from resected reginal lymph nodes seems to be associated with improved outcome. While there is no evidence for better survival with adjuvant chemotherapy after curative surgery, there has been a trend towards offering such treatment to patients in recent years. .

In the presence of metastases or when local resection is not possible, after palliative surgery, or after surgery with curative intent but with tumor present at the resection margins, chemotherapy may prolong survival.

Datum přednesení příspěvku: 18. 4. 2008