Synchronous primary duodenal bulb and cecal adenocarcinoma: case report and short review of the literature
BACKGROUND: Primary duodenal adenocarcinoma is a rare entity with an uncertain biologic behaviour whose diagnosis is usually achieved by endoscopy and biopsy. However, it lacks specific symptoms and its diagnosis may be delayed with poor prognosis. Villous adenomas are considered as premalignant lesions with high risk malignant transformation. METHODS: We report a rare case of a patient with two synchronous adenocarcinomas, one of the first portion of the duodenum as a villous tumor and the other in cecum colon. The patient submitted successfully to pacreatoduodenectomy and right hemicolectomy, while postoperatively received also adjuvant chemotherapy. RESULTS: Seventeen months after the operations the patient is alive with no evidence of recurrent or metastatic disease. CONCLUSIONS: The radical resection of primary duodenal adenocarcinoma is considered the treatment of choice, which should be accompanied by adjuvant chemotherapy preventing a recurrence at distant sites.
N. Andromanakos, D. Filippou, C. Spiliadi , A. Dimitrakopoulou, A. Papachristodoulou, A. Kostakis, European Surgery 3/2012