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Journal articles on the topic 'PRIMARY DUODENAL ADENOCARCINOMA'

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Author: Grafiati

Published: 11 March 2023

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1

Goldner, Bryan, and Bruce E. Stabile. "Duodenal Adenocarcinoma: Why the Extreme Rarity of Duodenal Bulb Primary Tumors?" American Surgeon 80, no. 10 (October 2014): 956–59. http://dx.doi.org/10.1177/000313481408001010.

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Adenocarcinoma of the small bowel accounts for only one per cent of all gastrointestinal malignancies. Duodenal adenocarcinoma accounts for half of all small bowel adenocarcinomas. The duodenum is divided into four segments: D1 (proximal horizontal 5 cm beginning with the 3-cm duodenal bulb), D2 (descending), D3 (distal horizontal), and D4 (ascending). The most common location of duodenal adenocarcinomas is the ampullary region of D2. Based on observational experience, our hypothesis was that primary adenocarcinomas arising from the mucosa of the duodenal bulb are extremely rare or possibly nonexistent. Our institutional cancer registry provided a list of patients for the years 1990 through 2012 who had small bowel cancers. Only those patients with primary adenocarcinomas of the duodenal mucosa were reviewed. Ampullary cancers arising from bile duct mucosa were specifically excluded. Medical records were abstracted to obtain patient age, sex, race, anatomic location of the tumor, disease stage (as per American Joint Committee on Cancer 7th edition staging guidelines), operation performed, and current vital status. A total of 30 patients with primary duodenal adenocarcinomas were identified. The mean age was 58 years and 17 (57%) patients were male. The tumor locations were: D2 in 26 (87%), D3 in two (7%), and D4 in two (7%). No tumors arose from D1. The patients presented with the following stages of disease: Stage 0 is in three (10%), Stage I in three (10%), Stage II in five (17%), Stage III in 15 (50%), and Stage IV in four (13%). These findings combined with a diligent review of 724 reported cases in the English language literature yielded only five clearly defined cases of adenocarcinoma arising from the mucosa of the duodenal bulb. Although a 1991 published multicenter tumor registry series of 128 localized duodenal adenocarcinomas reported 29 D1 tumors, no anatomic distinction was made between duodenal bulb and more distal D1 tumors. Earlier reports used nonanatomic divisions of the duodenum or a simple breakdown into supra-ampullary, periampullary, and infra-ampullary portions. These data beg the question as to why primary duodenal bulb adenocarcinomas are so exceedingly rare. The obvious implication is that the duodenal bulb mucosa may be physiologically, immunologically, or otherwise uniquely privileged to virtually escape oncogenic transformation. The scientific challenge and opportunity is to explore and understand the important phenomena responsible for this finding.

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2

Solej, Mario, Silvia D'Amico, Gabriele Brondino, Marco Ferronato, and Mario Nano. "Primary Duodenal Adenocarcinoma." Tumori Journal 94, no. 6 (November 2008): 779–86. http://dx.doi.org/10.1177/030089160809400601.

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Aims and Background Primary duodenal adenocarcinoma is a rare tumor with a poorly defined natural history and prognostic factors. It presents with nonspecific symptoms, and for this reason the diagnosis is often delayed. It is a serious problem for the surgeon because of the difficulty in obtaining an early diagnosis and standardizing basic tenets for an appropriate surgical approach. The aim of this work was to conduct a review of the literature analyzing the points most frequently debated about this pathology. Methods and Study Design A bibliographic search was carried out on the main search engines to find studies regarding duodenal adenocarcinoma, published in English, from January 1992 to January 2007. Results A total of 19 articles was selected. Results concerning symptoms, location of the tumor, diagnostic examinations, surgical treatment, histopathology of the tumor, survival and follow-up were obtained and discussed. Conclusions All patients who are medically fit to undergo surgery should be given the option of aggressive resection regardless of tumor size, tumor invasion or appearance of positive lymph nodes. Hopefully, an early diagnosis will correlate with improved long-term survival.

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3

Ryder, Nova M. "Primary Duodenal Adenocarcinoma." Archives of Surgery 135, no. 9 (September 1, 2000): 1070. http://dx.doi.org/10.1001/archsurg.135.9.1070.

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4

Varshney, Vaibhav Kumar, Bharti Varshney, Sudeep Khera, and Binit Sureka. "Adenocarcinoma of the fourth portion of duodenum presenting as intussusception: an unusual manifestation of rare pathology." BMJ Case Reports 14, no. 7 (July 2021): e244034. http://dx.doi.org/10.1136/bcr-2021-244034.

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Primary adenocarcinoma of the fourth portion of the duodenum (D-IV) is reported infrequently than other parts of the duodenum. Its diagnosis is often late because of non-specific symptoms and signs. We encountered a 48-year-old male patient who was diagnosed as duodeno-duodenal intussusception, underwent segmental duodenal resection with duodenojejunal anastomosis and confirmed as adenocarcinoma of D-IV. He received adjuvant chemotherapy and is doing well at 1 year of follow-up. This report describes about the rare case of isolated adenocarcinoma of the D-IV presented as intussusception which is never reported before and successfully treated by segmental resection of the duodenum and jejunum.

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5

Soni, Subhash, Vaibhav Varshney, Manu Goyal, and Shashank Shekher. "Radical resection for duodenal carcinoma with isolated bilateral ovarian metastasis: a case report." International Surgery Journal 6, no. 12 (November 26, 2019): 4554. http://dx.doi.org/10.18203/2349-2902.isj20195430.

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Natural history of duodenal adenocarcinoma is not well known. Although extremely rare, the incidence of primary small bowel adenocarcinoma has been increasing. Primary duodenal cancer is a very rare, which has accounted for only 0.3% of all gastrointestinal cancers. Isolated ovarian metastasis from duodenal carcinoma is extremely rare entity. We report a case of duodenal carcinoma with isolated bilateral ovarian metastasis in a 39-year-old female patient managed surgically with Whipple’s procedure with bilateral oophorectomy. She presented with complaints of dyspepsia and intermittent vomiting since 1½ years. History of anorexia and weight loss present. Upper gastrointestinal endoscopy was suggestive of circumferential ulcerated friable lesion at duodenum (D1-2) region and histopathology suggestive of moderately differentiated adenocarcinoma. Subsequent imaging studies revealed 6×5 cm duodenal mass in D1 and D2 without IHBRD with right ovarian mass. She underwent staging laparoscopy with open classic Whipple’s procedure with bilateral oophorectomy was done. Intraoperatively 6×6 cm mass involving first and second part of duodenum involving head of pancreas was found with 3×3 cm right ovarian mass. Post-operative period was uneventful and she discharged on POD6. Final biopsy was suggestive of moderately differentiated adenocarcinoma of duodenum with bilateral ovarian metastasis and she received adjuvant chemotherapy. Now at 1 year, on regular follow up she is completely asymptomatic and imaging showed no recurrent disease. Isolated ovarian metastasis may not be a contraindication for radical surgery in selected group of patients with duodenal carcinoma.

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6

Kawahira, Hiroshi, Fumihiko Miura, Kenichi Saigo, Akinao Matsunaga, Toshiyuki Natsume, Takashi Akai, Daisuke Horibe, et al. "Survival Predictors of Patients With Primary Duodenal Adenocarcinoma." International Surgery 96, no. 2 (April 1, 2011): 111–16. http://dx.doi.org/10.9738/1381.1.

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Abstract This single-institution experience retrospectively reviewed the outcomes in 21 patients with primary duodenal adenocarcinoma. Twelve patients underwent curative surgery, and 9 patients underwent palliative surgery at the Chiba University Hospital. The maximum follow-up period was 8650 days. All pathologic specimens from endoscopic biopsy and surgical specimens were reviewed and categorized. Twelve (57.1%) patients underwent curative surgery (R0): 4 pancreaticoduodenectomies (PD), 4 pylorus-preserving PDs (PpPD), 2 local resections of the duodenum and 2 endoscopic mucosal resections (EMR). Palliative surgery was performed for 9 patients (42.9%) following gastro-intestinal bypass. The median cause-specific survival times were 1784 days (range 160–8650 days) in the curative surgery group and 261 days (range 27–857 days) in the palliative surgery group (P = 0.0003, log-rank test). The resectability of primary duodenal adenocarcinoma was associated with a smaller tumor size, a lower degree of tumor depth invasiveness, and less spread to the lymph nodes and distant organs.

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7

Gandhi, Sejal, Tariq Niazi, Lisa Patel, Kavita Gupta, and Fengming Zhong. "The Bizarre Tumor: Primary Duodenal Adenocarcinoma." American Journal of Gastroenterology 107 (October 2012): S351—S352. http://dx.doi.org/10.14309/00000434-201210001-00855.

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8

Lee, Hyung Geun, Dong Do You, Kwang Yeol Paik, Jin Seok Heo, Seong Ho Choi, and Dong Wook Choi. "Prognostic Factors for Primary Duodenal Adenocarcinoma." World Journal of Surgery 32, no. 10 (July 31, 2008): 2246–52. http://dx.doi.org/10.1007/s00268-008-9678-6.

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9

Parmar, Parth, Shadan Ali, Romesh Lal, Saurabh Borgharia, Manoj Andley, and Gyan Saurabh. "Duodenal adenocarcinoma: a rare cause of intestinal obstruction in young adult." International Surgery Journal 8, no. 3 (February 25, 2021): 1030. http://dx.doi.org/10.18203/2349-2902.isj20210943.

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Primary adenocarcinoma of duodenum is a very rare and aggressive malignancy, found in middle or elderly age group and usually arising in the second portion of the duodenum, followed by third or fourth. Cancers of the first portion of the duodenum, especially the duodenal bulb are extremely rare. The causative factors for duodenal adenocarcinoma are dietary factors, ingestion of alcohol, coffee and use of tobacco. It may occur from duodenal polyps present in familial polyposis or may be associated. In young age it is associated with polyposis syndromes or with Crohn’s disease affecting small bowel. Very few reports discuss the diagnosis and treatment of such malignancy and very few cases have been reported in young age less than 30years. We are reporting a case of 22 years old gentleman who presented to us with history of recurrent abdominal pain and vomiting. After evaluation it was diagnosed as adenocarcinoma of third and fourth part of duodenum without any associated syndromes or inflammatory bowel diseases and was managed by surgical resection and chemotherapy.

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10

Moreno Loaíza, Óscar, and Diana Neira Rojas. "Primary duodenal adenocarcinoma: case report of an infrequent tumor." Medwave 13, no. 09 (October 25, 2013): e5821-e5821. http://dx.doi.org/10.5867/medwave.2013.09.5821.

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11

Wakatsuki, Takeru, Atsushi Irisawa, Tadayuki Takagi, Yoshihisa Koyama, Sayuri Hoshi, Seiichi Takenoshita, Masafumi Abe, and Hiromasa Ohira. "Primary Adenocarcinoma of the Minor Duodenal Papilla." Yonsei Medical Journal 49, no. 2 (2008): 333. http://dx.doi.org/10.3349/ymj.2008.49.2.333.

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12

Saito, Tomohiro, Kiyoshi Nakamura, Yoshio Konishi, Masaru Sawataishi, and Masao Fujimaki. "Primary Advanced Adenocarcinoma of the Duodenal Bulb." Japanese Journal of Gastroenterological Surgery 27, no. 9 (1994): 2161–65. http://dx.doi.org/10.5833/jjgs.27.2161.

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13

Khan, Sohaib, Nagaraj Sanchita Honganur, Amanda Sullivan, Kumari Piryanka, Talha Tahir, and Paula Dionisio. "S3467 Primary Duodenal Adenocarcinoma: A Rare Malignancy." American Journal of Gastroenterology 117, no. 10S (October 2022): e2183-e2183. http://dx.doi.org/10.14309/01.ajg.0000870508.05831.42.

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14

Elrod, Sarah, Kyle Marrache, and Zulfiqar Arif. "S3437 Initial Presentation of Primary Duodenal Adenocarcinoma." American Journal of Gastroenterology 117, no. 10S (October 2022): e2168-e2168. http://dx.doi.org/10.14309/01.ajg.0000870388.69864.68.

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15

Yamamoto, Naoto, Kota Washimi, Masaaki Murakawa, Mariko Kamiya, Yuto Kamioka, Makoto Ueno, Takeshi Kishida, Yasushi Rino, Munetaka Masuda, and Soichiro Morinaga. "Primary Duodenal Carcinoma with Embryonal Carcinoma Features in a Young Man." Case Reports in Gastroenterology 15, no. 1 (March 4, 2021): 269–75. http://dx.doi.org/10.1159/000512421.

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We present the case of a 35-year-old man with intractable nausea, vomiting, and severe anemia. A computed tomography (CT) scan of the chest, abdomen, and pelvis showed a circumferential lesion thickening of up to 3.5 cm at the level of the third portion of the duodenum. No aortocaval, retroperitoneal lymphadenopathy, nor secondary lesion was observed. Esophagogastroduodenoscopy (EGD) revealed a circumferential mass within the third portion of the duodenum. Histopathology of biopsy materials from the duodenal mass showed it most likely to be a poorly differentiated adenocarcinoma. The patient underwent a subtotal stomach-preserving pancreaticoduodenectomy with regional lymph node dissection. Histologically, tumor cells with basophilic cytoplasm and pleomorphic nuclei showed a solid pattern, and expressed CD30 and SALL4 immunohistochemically, leading to a diagnosis of embryonal carcinoma-like tumor. No other primary tumor could be identified, and the location of the tumor, mainly on the mucosal surface, suggested a duodenal origin. The UICC TNM staging was T3N2M0, stage IIB. This is a rare case of primary duodenal carcinoma with features of embryonal carcinoma.

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16

Gomes, Lilian Brito, Jonathan Dos Santos Lima, Dayane Brito Gomes, Jacqueline Stephanie Fernandes Do Nascimento, Nicolle Dos Santos Moraes Nunes, Marco Orsini, Gilberto Canedo Martins Jr, and Antonio Marcos Da Silva Catharino. "Primary Duodenal Adenocarcinoma: Case report and literature review." Gazette of Medical Sciences 2, no. 1 (January 26, 2021): 21–25. http://dx.doi.org/10.46766/thegms.oncol.21012102.

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Primary adenocarcinoma of the duodenum is a rare clinical condition, accounting for only 5% of all gastrointestinal neoplasms and 0.5% of all intestinal neoplasms. Nonspecific clinical presentation contributes to the majority of cases being diagnosed in advanced stages. The prognosis is poor, with a median survival of five years, varying from 23% to 57% in patients undergoing curative surgery (cephalic duodenopancreatectomy).

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17

Joo, Young-Eun, Hyun-Soo Kim, Sung-Kyu Choi, Jong-Sun Rew, Chang-Soo Park, and Sei-Jong Kim. "Primary duodenal adenocarcinoma associated with neurofibromatosis type 1." Journal of Gastroenterology 37, no. 3 (February 2, 2002): 215–19. http://dx.doi.org/10.1007/s005350200024.

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18

Ohkusa, Toshifumi, Kenichiro Ohtomo, Nobuhiko Yamamoto, and Hideaki Fujimoto. "Primary adenocarcinoma of duodenal bulb benefitted by chemotherapy." Digestive Diseases and Sciences 36, no. 11 (November 1991): 1653–56. http://dx.doi.org/10.1007/bf01296412.

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19

Jiang, Qing-Long, Xiang-Hui Huang, Ying-Tai Chen, Jian-Wei Zhang, and Cheng-Feng Wang. "Prognostic Factors and Clinical Characteristics of Patients with Primary Duodenal Adenocarcinoma: A Single-Center Experience from China." BioMed Research International 2016 (2016): 1–6. http://dx.doi.org/10.1155/2016/6491049.

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Aim. To evaluate the clinical risk factors influencing overall survival of patients with duodenal adenocarcinoma after potentially curative resection. Methods. A series of 201 patients with primary duodenal adenocarcinoma who underwent surgery from 1999 to 2014 at Chinese Medical Academic Cancer Hospital were studied by retrospective chart review and subsequent telephone follow-up. Results. Resectional surgery was performed in 138 of the 201 patients to attempt curative treatment, while 63 patients were treated with palliative surgery. Median survival of patients who underwent resectional operation was 57 months, whereas that of patients who had palliative surgery was shorter, 7 months (p<0.001). For patients who underwent radical resection, the overall 1-, 3-, and 5-year survival rates were 87.3, 59.1, and 44.1%, respectively. Multivariate Cox regression analysis revealed that lymph node metastasis (HR 31.76, 2.14 to 470.8; p=0.012) and vascular invasion (HR 3.75, 1.24 to 11.38; p=0.020) were independent prognostic factors negatively associated with survival in patients undergoing curative resection. There was no survival difference between the groups treated by the pancreaticoduodenectomy (n=20) and limited resection (n=10) for early-stage duodenal adenocarcinoma (p=0.704). Conclusions. Duodenal adenocarcinoma is a rare disease. Curative resection is the best treatment for appropriate patients. Lymph node metastases and vascular invasion are negative prognostic factors.

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20

Cheung, Onki, Hossam Kandil, Arthur J. Moser, Patricia A. Swalsky, Eizaburo Sasatomi, and Sydney D. Finkelstein. "Primary Duodenal Carcinoma Showing Divergent Growth Patterns as Determined by Microdissection-Based Mutational Genotyping." Archives of Pathology & Laboratory Medicine 127, no. 7 (July 1, 2003): 861–64. http://dx.doi.org/10.5858/2003-127-861-pdcsdg.

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Abstract Primary duodenal adenocarcinoma accounts for less than 0.5% of all gastrointestinal cancers. We report a case of duodenal adenocarcinoma with highly divergent growth patterns consisting of poorly differentiated adenocarcinoma and neuroendocrine carcinoma proven to arise as a single neoplasm of monoclonal origin, as demonstrated by microdissection-based mutational profiling. Multicomponent growth patterns, as seen in this case, can occasionally be encountered in gastrointestinal malignancies and have led to speculation about the pathogenesis. The methods used to clearly establish monoclonal origin based on the unique profiling of mutational damage can address fundamental issues related to tumor development and progression, while providing cogent clinical information. Our findings confirm the great potential for intestinal epithelial cells to differentiate along different histogenetic lines during tumor progression.

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21

Li, Fuqiang, Jiren Yu, and Zili Yang. "Sister Mary Joseph’s Nodule Originating From Primary Duodenal Adenocarcinoma." American Journal of the Medical Sciences 344, no. 1 (July 2012): 40. http://dx.doi.org/10.1097/maj.0b013e318239fa0f.

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22

Solaini, Leonardo, Nigel B. Jamieson, Riccardo Tamburrini, Gabriele Spoletini, Mohammad Abu Hilal, Colin D. Johnson, Zahir Soonawalla, Brian Davidson, Colin McKay, and Hemant Koche. "Sa1937 UK Multicentre Surgical Experience With Primary Duodenal Adenocarcinoma." Gastroenterology 146, no. 5 (May 2014): S—334. http://dx.doi.org/10.1016/s0016-5085(14)61206-3.

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23

Han, Shao-Liang, Jun Cheng, Hong-Zhong Zhou, Qi-Qiang Zeng, and Sheng-Hong Lan. "The Surgical Treatment and Outcome for Primary Duodenal Adenocarcinoma." Journal of Gastrointestinal Cancer 39, no. 1-4 (March 2008): 46–50. http://dx.doi.org/10.1007/s12029-009-9061-3.

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24

Han, Shao-liang, Jun Cheng, Hong-zhong Zhou, Qi-Qiang Zeng, and Sheng-Hong Lan. "The Surgical Treatment and Outcome for Primary Duodenal Adenocarcinoma." Journal of Gastrointestinal Cancer 40, no. 1-2 (June 2009): 33–37. http://dx.doi.org/10.1007/s12029-009-9073-z.

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25

Han, Shao-Liang, Jun Cheng, Hong-Zhong Zhou, Qi-Qiang Zeng, and Sheng-Hong Lan. "The Surgical Treatment and Outcome for Primary Duodenal Adenocarcinoma." Journal of Gastrointestinal Cancer 41, no. 4 (April 30, 2010): 243–47. http://dx.doi.org/10.1007/s12029-010-9160-1.

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26

Yang, Jiyoul, Ho-chang Lee, Ok-Jun Lee, Daehwan Bae, Seungjun Jeong, Moon Ki Choi, Jihyun Kwon, and Hye Sook Han. "Synchronous double primary renal cell carcinoma and duodenal adenocarcinoma." Journal of Biomedical Translational Research 17, no. 3 (September 2016): 70–74. http://dx.doi.org/10.12729/jbtr.2016.17.3.070.

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27

Haydel, Seth, Conar Fitton, and Catherine Hudson. "S3399 Duodenal Metastasis From Primary Adenocarcinoma of the Lung." American Journal of Gastroenterology 117, no. 10S (October 2022): e2149-e2150. http://dx.doi.org/10.14309/01.ajg.0000870236.13936.2c.

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28

Saito, Hitoshi, Yoshiaki Osaka, Kazuhiko Tamura, Hideaki Kawakita, Nao Kobayashi, Yuichi Nagakawa, Kenji Katsumata, and Akihiko Tsuchida. "Collision Tumor of Adenocarcinoma and Gastrointestinal Stromal Tumor in the Small Bowel." Case Reports in Gastroenterology 12, no. 3 (November 28, 2018): 715–21. http://dx.doi.org/10.1159/000495246.

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We report a very rare case of collision tumor composed of primary adenocarcinoma of the jejunum and gastrointestinal stromal tumor (GIST). The patient was a 63-year-old man who visited our hospital for epigastralgia and vomiting. Abdominal computed tomography revealed a mass in the upper jejunum, with gastric and duodenal dilatation. Endoscopy of the small bowel showed a circumferential tumor in the upper jejunum, which was diagnosed as primary adenocarcinoma by tissue biopsy. Thereafter, partial resection of the small bowel from the third part of the duodenum over the upper jejunum was performed. A tumor colliding with the primary adenocarcinoma was identified on the serosal side of the jejunum in the excised specimen and was histologically diagnosed as GIST. The annual incidence of primary adenocarcinoma of the small bowel (i.e., jejunum and ileum excluding the duodenum) has been reported to be 7 in 1 million people, and only 6 cases of collision tumor of the small bowel (i.e., duodenum: 5, ileum: 1) have been reported thus far. Although esophageal, gastric, and large intestinal collision tumors composed of primary cancer and GIST have been reported, to our knowledge, the present patient is the first case of the small bowel. The cause of or correlation between 2 tumors forming a collision tumor remains unclear. In the present patient, there was no pathological finding of infiltration between the 2 tumors. Although the collision of the 2 tumors was unclear, the findings indicate their independent development in closely located regions consistent with collision tumors.

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29

Chiu, R., and C. G. Yap. "Two Cases of Duodenal Neuroendocrine (Carcinoid) Tumor Concurrent with Invasive Gastric Adenocarcinoma and Pancreatic Intraductal Papillary Mucinous Neoplasm." American Journal of Clinical Pathology 158, Supplement_1 (November 1, 2022): S68. http://dx.doi.org/10.1093/ajcp/aqac126.137.

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Abstract Introduction/Objective Neuroendocrine (carcinoid) tumors of the duodenum are extremely rare and account for only 2-4% of gastrointestinal tract neuroendocrine tumors. We report two cases of incidentally discovered duodenal neuroendocrine tumor which respectively occurred in a patient with invasive gastric adenocarcinoma and in a patient with pancreatic intraductal papillary mucinous neoplasm (IPMN). Methods/Case Report The first case involved a 60-year old male who presented with melena and symptomatic anemia and was found on EGD to have a large circumferential mass at the gastric antrum/pylorus, which was revealed to be an invasive gastric adenocarcinoma on biopsy. At the time of distal gastrectomy for this malignancy, a concurrent, 0.6 cm-sized, low grade neuroendocrine tumor was incidentally discovered at the duodenal margin. The duodenal tumor consisted of nests and trabeculae of monotonous cells with ovoid/round nuclei, finely speckled “salt and pepper” chromatin, and low mitotic rate (< 2 mitoses/2 mm2), and invaded only into submucosa. The tumor cells were strongly and diffusely positive for neuroendocrine markers chromogranin, synaptophysin, and CD56, positive for CK7 and CDX2, negative for CK20, and with low Ki67 proliferation index (< 3%). The second case involved a 69-year old female who presented with epigastric pain and was found on abdominal CT to have a 4 cm-sized cystic mass in the pancreatic head. While biopsy of the pancreatic mass revealed an IPMN, a separate biopsy of an incidentally discovered, 1 cm-deep ulcer in the duodenum bulb revealed a low-grade neuroendocrine tumor with similar morphologic features, mitotic rate, and immunohistochemical staining pattern as the prior case while also negative for IMP3 stain. The patient had normal serum gastrin and urine HIAA levels, but elevated serum chromogranin-A levels. Results (if a Case Study enter NA) NA. Conclusion Duodenal carcinoids are rare (1-3% of primary duodenal tumors) and are mostly non-functional and unifocal. The duodenum is also the least common site (2-4%) for GI tract neuroendocrine tumors. The pathophysiology of these tumors is still poorly understood, with the majority occurring sporadically and a minority in the setting of hereditary cancer syndromes. This report documents two very rare instances of duodenal neuroendocrine tumor incidentally discovered with invasive gastric adenocarcinoma and pancreatic IPMN.

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30

Chou, Jen-Wei, and Ken-Sheng Cheng. "Capsule retention caused by duodenal metastases from primary appendiceal adenocarcinoma." Intestinal Research 15, no. 1 (2017): 130. http://dx.doi.org/10.5217/ir.2017.15.1.130.

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31

FUJIMOTO, Jiro, Kazuhiro SUZUMURA, Nobukazu KURODA, Yuji IIMURO, Akito YADA, and Keiji NAKASHO. "A case of primary adenocarcinoma of the minor duodenal papilla." Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 73, no. 8 (2012): 1970–73. http://dx.doi.org/10.3919/jjsa.73.1970.

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32

Shenoy, Ranjeetha, Kalpana Shridhar, Suhas Kumar, and Prita Jagtap. "Primary Duodenal Adenocarcinoma with Hepatic Metastasis: A Rare Case Report." Annals of Health and Health Sciences 1, no. 2 (2014): 143. http://dx.doi.org/10.5958/2322-0422.2014.00531.1.

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33

Mizuma, Masamichi, Shuichi Ishiyama, Junichiro Yamauchi, Noriko Kondo, Takayuki Miura, Hiromune Shimamura, Yoichi Narushima, and Takayuki Yamaki. "Four Cases of Primary Duodenal Adenocarcinoma in the Fourth Portion." Japanese Journal of Gastroenterological Surgery 44, no. 6 (2011): 684–91. http://dx.doi.org/10.5833/jjgs.44.684.

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34

Tang, Guang-Hua, Chang-Lai Fu, Ji-Pin Shan, Dan-Bin Jiang, Jian-Qin Zhu, and Ying-Ying Zheng. "Primary polypoid adenocarcinoma of the duodenal bulb: A case report." World Chinese Journal of Digestology 24, no. 27 (2016): 3930. http://dx.doi.org/10.11569/wcjd.v24.i27.3930.

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35

Hung, Fu-Chih, Chung-Mou Kuo, Seng-Kee Chuah, Chung-Huang Kuo, Yaw-Sen Chen, Sheng-Nan Lu, and Chi-Sin Chang Chien. "Clinical analysis of primary duodenal adenocarcinoma: An 11-year experience." Journal of Gastroenterology and Hepatology 22, no. 5 (April 18, 2007): 724–28. http://dx.doi.org/10.1111/j.1440-1746.2007.04935.x.

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36

Rick, T., E. Stock, I. Van de Maele, E. Kammergruber, and J. Saunders. "Duodenal peripapillary adenocarcinoma causing extrahepatic biliary obstruction and icterus in a cat." Vlaams Diergeneeskundig Tijdschrift 89, no. 5 (October 30, 2020): 273–77. http://dx.doi.org/10.21825/vdt.v89i5.16954.

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A six-year-old, female, neutered domestic shorthair cat was presented with chronic weight loss and a two-day history of partial anorexia and lethargy. Abdominal ultrasonography revealed a regional thickening of the duodenal wall with loss of normal layering, a normally walled segmentally dilated distal aspect of the common bile duct containing slightly hyperechoic bile, and a mild to moderately enlarged major duodenal papilla. Based on the ultrasound examination, the primary differential diagnosis was a peripapillary duodenal neoplastic or less likely, an inflammatory or infectious process with secondary extrahepatic biliary obstruction. Postmortem examination revealed a duodenal, peripapillary adenocarcinoma with metastasis into the liver and lymph nodes, and external compressive obstruction of cystic- and common bile duct.

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37

Hsiao, Susan Jean, and Helen Elaine Remotti. "Beta-catenin and p53 expression in ampullary and small intestinal adenocarcinoma." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e14659-e14659. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e14659.

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e14659 Background: Small intestinal adenocarcinomas are rare tumors with a worse prognosis than tumors arising from the large intestine. The majority of small intestinal adenocarcinomas arise in duodenum, most commonly around the ampulla of Vater; a smaller subset arises from the jejunum and ileum. Small intestinal adenocarcinomas remain poorly characterized due to their rarity, and limited options exist for adjuvant chemotherapy. Characterization of accumulation of the p53 tumor suppressor and aberrant expression of beta-catenin, suggestive of activation of the Wnt signaling pathway, could have important clinical implications and provide therapeutic targets. Methods: Tissue microarrays of ampullary and small intestinal adenocarcinomas were created using 2 cores of formalin-fixed tissues from 57 patients who had undergone surgical resection. Primary tumors involved the ampulla of Vater in 49% of cases, peri-ampullary duodenum in 39% of cases, and jejunum/ileum in 12% of cases.Immunohistochemical stains were performed for beta-catenin and p53. Cases with accumulation of p53 were scored as positive. Normal localization of beta-catenin is membranous; nuclear (or nuclear and cytoplasmic) accumulation of beta-catenin was scored as positive. Results: Accumulation of the p53 tumor suppressor protein was observed in 67.9% of ampullary adenocarcinomas, 86.4% of peri-ampullary/duodenal adenocarcinomas, and 57.1% of jejunal/ileal adenocarcinomas. Aberrant localization of beta-catenin was observed in 10.7% of ampullary adenocarcinomas, 0% of peri-ampullary/duodenal adenocarcinomas, and 42.9% of jejunal/ileal adenocarcinomas. Conclusions: Our initial results show accumulation of p53 in a substantial proportion of cases, similar to that which has been observed in other tumors. Abnormalities in p53 is one of the most common mutations observed in tumors. This is a clinically important result, as these tumors may respond to specific therapies targeting p53. In addition, our results implicate the Wnt signaling pathway in a subset of jejunal/ileal and ampullary adenocarcinomas offering another possible avenue for targeted therapies.

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Li, Teng-Yan, Qi-Chen Chen, Hong Zhao, Ye-Fan Zhang, Jian-Jun Zhao, and Jian-Qiang Cai. "Prognostic factors for overall survival in patients with primary duodenal adenocarcinoma." Annals of Palliative Medicine 10, no. 3 (March 2021): 2781–90. http://dx.doi.org/10.21037/apm-20-1280.

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Urabe, M., J. Shindoh, Y. Kobayashi, S. Okubo, S. Haruta, M. Ueno, and M. Hashimoto. "Factors impacting survival outcomes after curative resection for primary duodenal adenocarcinoma." HPB 23 (2021): S282. http://dx.doi.org/10.1016/j.hpb.2020.11.712.

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Urabe, Masayuki, Junichi Shindoh, Yuta Kobayashi, Satoshi Okubo, Shusuke Haruta, Masaki Ueno, and Masaji Hashimoto. "Factors Impacting Survival Outcomes after Curative Resection for Primary Duodenal Adenocarcinoma." Surgery, Gastroenterology and Oncology 25, no. 3 (2020): 132. http://dx.doi.org/10.21614/sgo-25-3-132.

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Chen, Jie, Qu Lin, Jing-Yun Wen, Xing Li, Xiao-Kun Ma, Xin-Juan Fan, Qin-Hua Cao, et al. "Prognosis value of mitotic kinase Aurora-A for primary duodenal adenocarcinoma." Tumor Biology 35, no. 9 (June 20, 2014): 9361–70. http://dx.doi.org/10.1007/s13277-014-2215-3.

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Li, Debang, Xiaoying Si, Tao Wan, and Yanming Zhou. "Outcomes of surgical resection for primary duodenal adenocarcinoma: A systematic review." Asian Journal of Surgery 42, no. 1 (January 2019): 46–52. http://dx.doi.org/10.1016/j.asjsur.2018.04.005.

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Chung, Woo Chul, Chang Nyol Paik, Sung Hoon Jung, Kang-Moon Lee, Sang Woo Kim, U.-Im Chang, and Jin Mo Yang. "Prognostic Factors Associated with Survival in Patients with Primary Duodenal Adenocarcinoma." Korean Journal of Internal Medicine 26, no. 1 (2011): 34. http://dx.doi.org/10.3904/kjim.2011.26.1.34.

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Wei, Xin, Ke Chen, Dong-chang Li, He Li, Liang Zhu, and Zheng-guang Wang. "Risk and Prognostic Factors for Small Bowel Adenocarcinoma: A Multicenter Retrospective Observational Study in China." Clinical Medicine Insights: Oncology 16 (January 2022): 117955492210912. http://dx.doi.org/10.1177/11795549221091207.

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Background: Small bowel adenocarcinoma (SBA) is a rare malignancy that accounts for 3% of all gastrointestinal tumors. We evaluated the clinical characteristics, outcomes, and prognostic factors of primary SBAs. Methods: We retrospectively analyzed the clinicopathological features and clinical outcomes of 300 patients with SBA from three institutions in China between January 2003 and July 2020. Overall survival (OS) was analyzed using the Kaplan–Meier method and it was statistically compared using the log-rank test. Single-variable and multivariate analyses were used to identify the significant correlates of OS. Results: The primary tumor was on the duodenal papilla in 156 patients (52%), in the duodenum in 60 patients (20%), and in the jejunum–ileum in 84 patients (28%). The median OS of the entire cohort was 32.5 months (range, 0-213 months), with a 1-year OS rate of 78.0%. For jejunoileal adenocarcinoma, advanced age, advanced T stage, advanced N stage, more positive lymph nodes, distant metastasis, high carcinoembryonic antigen (CEA), and lymphocyte-to-monocyte ratio < 2.32 predicted worse survival on single-variable analysis. Multivariate analysis showed that advanced age, advanced tumor node metastases (TNM) stage, high CEA level, high alpha fetoprotein (AFP) level, and low prealbumin level were independent prognostic factors for non-ampullary SBA. The independent prognostic factors for duodenal papilla adenocarcinoma included TNM Stage III, nerve invasion, low platelet/lymphocyte ratio, and high CA19-9. Conclusion: We found different independent prognostic factors for tumors at different locations. This finding warrants further investigation to ensure more effective management strategies for SBA.

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Oyasiji, Tolutope, Julie Alosi, Wei Tan, Chandler Wilfong, and Neal Wilkinson. "Duodenal Adenocarcinoma: Profile and Predictors of Survival Outcomes." American Surgeon 81, no. 11 (November 2015): 1125–33. http://dx.doi.org/10.1177/000313481508101124.

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Duodenal adenocarcinoma is rare. We aimed to evaluate survival outcome and prognostic factors for survival in patients with duodenal adenocarcinoma in recent years, marked by advancement in chemotherapy for gastrointestinal cancers. All patients treated for duodenal adenocarcinoma at our institution between January 2000 and July 2013 were reviewed. Thirty-nine patients were identified: 27 operative patients [21(53.8%) curative and 6 (15.4%) palliative operations] and 12 nonoperative patients [primary systemic chemotherapy, 4 (10.3%), palliative radiotherapy, 1 (2.6%), and no treatment, 7 (17.9%)]. Curative resections included 13 pancreaticoduodenectomies and eight segmental resections. Median overall survival (OS) for entire cohort was 14.4 months. Median OS and one-, three-, and five-year OS were operative group (41.4 months; 79.1%, 50.6%, and 10.6%, respectively); nonoperative group (7.4 months; 25.0%, 8.3%, and 0%, respectively); curative surgery (45.4 months; 92.9%, 62.5%, and 16.7%, respectively) and palliative surgery (5.4 months; 33.3%, 16.7%, and 0%, respectively). Female gender ( P = 0.04), curative resection ( P = 0.03), nodal metastasis ( P = 0.047) and advanced T stage ( P = 0.047) were predictive of OS. Two factors were independently predictive of OS—female gender and curative resection. Overall survival still hinges on curative resection. This favors early detection. Adjuvant treatment modalities such as chemotherapy and radiation require further investigation.

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Hammami, Muhammad Bader, Anuj Chhaparia, Jinhua Piao, Yihua Zhou, Christine Hachem, and Jinping Lai. "Mixed Adenocarcinoma and Squamous Cell Carcinoma of Duodenum: A Case Report and Review of the Literature." Case Reports in Gastroenterology 11, no. 2 (July 4, 2017): 402–10. http://dx.doi.org/10.1159/000477715.

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Despite being the largest part of the human gastrointestinal (GI) tract, the small intestine accounts for only 1–1.4% of all GI malignancies. Adenocarcinoma is the most common primary small bowel malignancy, with the most common site being the duodenum. On the other hand, squamous cell carcinoma (SCC) of the duodenum is extremely uncommon. We report the first case of mixed adenocarcinoma and SCC occurring in the third part of duodenum (D3). Our patient, a 64-year-old female with history of GERD, hypertension, and IDDM presented with 4 weeks of nausea, vomiting, and abdominal pain. Tomographic imaging of her abdomen demonstrated a distended stomach and a proximal duodenum with narrow caliber changes at the level of D3. An EGD revealed a tight stricture at D3 that could not be traversed. Stricture biopsies revealed duodenal mucosa with two small foci of SCC (positive for p63 and CK5/6) and adenocarcinoma (positive for CK7 and Moc31). Peritoneal metastases were detected on exploratory laparotomy, making the tumor surgically incurable. As she progressively declined and with worsening liver enzymes and general debility, she was not a candidate for chemotherapy and was eventually discharged on home hospice. Small bowel SCC/adenocarcinoma is an exceedingly uncommon cancer, making further case reports such as ours important to understand the nature of this entity and establish management guidelines.

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Negoi, Ionut, Sorin Paun, Sorin Hostiuc, Bodgan Stoica, Ioan Tanase, Ruxandra Irina Negoi, and Mircea Beuran. "Most small bowel cancers are revealed by a complication." Einstein (São Paulo) 13, no. 4 (December 11, 2015): 500–505. http://dx.doi.org/10.1590/s1679-45082015ao3380.

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ABSTRACT Objective To characterize the pattern of primary small bowel cancers in a tertiary East-European hospital. Methods A retrospective study of patients with small bowel cancers admitted to a tertiary emergency center, over the past 15 years. Results There were 57 patients with small bowel cancer, representing 0.039% of admissions and 0.059% of laparotomies. There were 37 (64.9%) men, mean age of 58 years; and 72 years for females. Out of 57 patients, 48 (84.2%) were admitted due to an emergency situation: obstruction in 21 (38.9%), perforation in 17 (31.5%), upper gastrointestinal bleeding in 8 (14.8%), and lower gastrointestinal bleeding in 2 (3.7%). There were 10 (17.5%) duodenal tumors, 21 (36.8%) jejunal tumors and 26 (45.6%) ileal tumors. The most frequent neoplasms were gastrointestinal stromal tumor in 24 patients (42.1%), adenocarcinoma in 19 (33.3%), lymphoma in 8 (14%), and carcinoids in 2 (3.5%). The prevalence of duodenal adenocarcinoma was 14.55 times greater than that of the small bowel, and the prevalence of duodenal stromal tumors was 1.818 time greater than that of the small bowel. Obstruction was the complication in adenocarcinoma in 57.9% of cases, and perforation was the major local complication (47.8%) in stromal tumors. Conclusion Primary small bowel cancers are usually diagnosed at advanced stages, and revealed by a local complication of the tumor. Their surgical management in emergency setting is associated to significant morbidity and mortality rates.

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You, Hyun Seon, Jeong Woo Hong, Eun Young Yun, Jin Joo Kim, Jae Min Lee, Sang Soo Lee, Hong Jun Kim, et al. "Primary Non-ampullary Duodenal Adenocarcinoma: A Single-center Experience for 15 Years." Korean Journal of Gastroenterology 66, no. 4 (2015): 194. http://dx.doi.org/10.4166/kjg.2015.66.4.194.

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Wang, Wei, and Rong Liu. "Comparison of Robot and open pancreaticodenectomy for the treatment primary duodenal adenocarcinoma." HPB 21 (2019): S307. http://dx.doi.org/10.1016/j.hpb.2019.10.1839.

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Katakura, Yoshiki, Michihiro Suzuki, Mika Kobayashi, Kazunari Nakahara, Nobuyuki Matsumoto, and Fumio Itoh. "Remission of Primary Duodenal Adenocarcinoma with Liver Metastases with S-1 Chemotherapy." Digestive Diseases and Sciences 52, no. 4 (January 17, 2007): 1121–24. http://dx.doi.org/10.1007/s10620-006-9382-z.

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