Duodenal carcinoma at the ligament of Treitz. A molecular and clinical perspectiveReport as inadecuate




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BMC Gastroenterology

, 10:109

First Online: 17 September 2010Received: 27 April 2010Accepted: 17 September 2010

Abstract

BackgroundThere is very small occurrence of adenocarcinoma in the small bowel. We present a case of primary duodenal adenocarcinoma and discuss the findings of the case diagnostic modalities, current knowledge on the molecular biology behind small bowel neoplasms and treatment options.

CaseThe patient had a history of iron deficiency anemia and occult bleeding with extensive workup consisting of upper endoscopy, colonoscopy, capsule endoscopy, upper gastrointestinal series with small bowel follow through and push enteroscopy. Due to persistent abdominal pain and iron deficiency anemia the patient underwent push enteroscopy which revealed adenocarcinoma of the duodenum. The patient underwent en-bloc duodenectomy which revealed T3N1M0 adenocarcinoma of the 4th portion of the duodenum.

ConclusionsPrimary duodenal carcinoma, although rare should be considered in the differential diagnosis of occult gastrointestinal bleeding when evaluation of the lower and upper GI tract is unremarkable. We discuss the current evaluation and management of this small bowel neoplasm.

AbbreviationsGIGastrointestinal

SBNSmall bowel neoplasms

NCDBNational Cancer Data Base

SEERSurveillance Epidemiology End Results

ACAdenocarcinoma

HNPCChereditary nonpolyposis colorectal cancer

FAPfamilial adenomatous polyposis

OGIBObscure GI bleeding

CRCColorectal cancer

CTECT enterocolysis

PEPush enteroscopy

CECapsule endoscopy

BAEBalloon assisted enteroscopy

SBESingle Balloon enteroscopy

DBEDouble Balloon enteroscopy

PDpancreatoduodenectomy

DSduodenal segmentectomy

5-FU5-fluorouracil

MMRMismatch repair

MCRmutation cluster region

EGDesophagogastroduodenosopy

Electronic supplementary materialThe online version of this article doi:10.1186-1471-230X-10-109 contains supplementary material, which is available to authorized users.

Peter T Kalogerinis, John E Poulos, Andrew Morfesis, Anthony Daniels, Stavroula Georgakila and Alexandros G Georgakilas contributed equally to this work.

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Author: Peter T Kalogerinis - John E Poulos - Andrew Morfesis - Anthony Daniels - Stavroula Georgakila - Thomas Daignualt - Alexan

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