Adenocarcinoma of the third portion of the duodenum with an acute cholecystitis

Abstract

Primary adenocarcinoma of the third portion of the duodenum is rare. Therefore, few reports have investigated the diagnosis and treatment of this malignancy. In October 2012, a 52-year-old Japanese female was referred to our hospital complaining of epigastric pain due to acute cholecystitis. Subsequent esophagogastroduodenoscopy (EGD) revealed a depressed-type duodenal tumor 15mm in size on the third portion, while abdominal ultrasound and computed tomography scan revealed cholecystitis with a gallstone. Thereafter, partial duodenectomy and cholecystectomy was performed, with histological examination showing well- and moderately differentiated tubular adenocarcinoma without lymph node metastasis. According, a definitive diagnosis of T1N0M0, pStage IA duodenal adenocarcinoma was established according to the TNM classification of malignant tumors. The patient had an excellent recovery, with no duodenal carcinoma recurrence having been clinically diagnosed eight years post-surgery. The appreciation of the distal duodenum by EGD is important for the proper diagnosis and treatment of this rare early duodenal adenocarcinoma.