Experience in clinical diagnosis and treatment of duodenal tumors

Abstract

Small bowel tumors are rare tumors. Duodenal tumors occur more commonly compared with other small intestinal tumors. To summarize the clinicopathological features of duodenal tumors, in the present study 44 cases of duodenal tumors were collected, and the comparative clinicopathological characteristics between tumors of the ampulla and non-ampulla, the choice of treatment, and differences in the prognosis, were analyzed. The pathological type identified was predominantly adenocarcinoma; periampullary duodenal tumors were almost classifiable as adenocarcinoma in terms of their type. Non-ampulla duodenal tumors also included rare pathological types, such as stromal tumor and large B-cell lymphoma. The symptoms of duodenal tumors were non-specific, therefore rendering early diagnosis and treatment difficult. Due to jaundice, periampullary duodenal tumors were diagnosed earlier than non-ampulla duodenal tumors. Endoscopy and computed tomography (CT) examinations were valuable in terms of diagnosis, and were used as a means of screening. Carcinoembryonic antigen (CEA) and cancer antigen 199 (CA199) were revealed to be important as biomarkers. Radical surgery was the most effective treatment. Pancreaticoduodenectomy was revealed to be applicable in all cases of duodenal tumors. For non-ampulla duodenal tumors, partial duodenum resection and subtotal gastrectomy were appropriate for selection as methods of treatment. No survival benefits were identified for adjuvant chemotherapy. Duodenal tumors were shown to be a rare neoplasm with atypical symptoms; they should be diagnosed and treated as early as possible; CT and gastroscopy may be used for screening, radical surgery offers the best treatment; pancreatoduodenectomy is not the only surgery option available; and chemotherapy did not result in any survival benefits.

Stress in glaucoma, from theory to practice

“…GISTs are a type of non-directional differentiation tumours that independently originate from the primitive mesenchymal tissues of the gastrointestinal tract 13 . The incidence of GISTs is approximately 1-2 /200,000, and they may occur across the length of the entire digestive tract, the most affected sites being the stomach and the small bowel, while tumours of the duodenal stroma are less frequent, representing only 10% of the small intestine tumours 14 .…”

“…Duodenal stromal tumours are mostly localized in the descending and horizontal portion of the duodenum, and less often in the bulb and ascending portion. Some authors have reported that recurrent black stool is the most common clinical symptom of a duodenal stromal tumour 13 .…”

A Rare Case of Three Distinct Gastrointestinal Neoplasms Occurring Simultaneously in an Elderly Patient

“…The screening protocol, treatment approach, and clinical prognostic factors are still controversial [11]. Currently, the best management includes CT scan for screening, EGD for biopsy, and surgery for tumor removal [12]. Further studies are necessary to investigate the control of the disease and if adjuvant chemotherapy or radiotherapy can improve patient survival rate.…”

Obstructing Duodenal Diffuse Large B-cell Lymphoma with Peritoneal Lymphomatosis with Exceptional Response to R-CHOP

“…The predominant histological type is adenocarcinoma. Other less common histologies include carcinoid, lymphoma, and sarcoma [1-2]. These neoplasms often have similar clinical, radiologic, and morphologic features making the distinction difficult without tissue examination.…”