Primary Duodenal Adenocarcinoma.
Primary duodenal adenocarcinoma (PDA) accounts for 0.3%-1% of all gastrointestinal tumors and 25%-35% of all malignant tumors of the small intestine (1). The disease is usually diagnosed at the advanced stage. Approximately 45% of PDA cases arise at the third and fourth anatomical regions of the duodenum (2). Investigative methods of choice remain endoscopy and duodenography which, more often than not, demonstrate the site, severity, and length of the lesion. Regarding therapy, the only treatment for PDA that can be considered to lead to a cure is a radical surgical excision of the tumor. Radical pancreaticoduodenectomy is the classic curative operation and by far the foremost treatment choice for tumors of the duodenum. Chemotherapy has no part to play in primary treatment and information regarding its use as an adjuvant treatment is limited. Nodal involvement and the chance of curative resection are independent prognostic factors for PDA (3). The five-year survival rate for patients with PDA who have underwent a curative resection is somewhere in the range of 50%-60%. This is better in comparison to tumors of the ampulla, distal bile duct, and head of the pancreas.
The Whipple procedure provides the best chance of successful treatment for duodenal adenocarcinoma patients. The roles of adjuvant chemotherapy and radiotherapy in the treatment of PDA remain unclear.
Informed Consent: Written informed consent was obtained from patients who participated in this study.
Peer-review: Externally peer-reviewed.
Author Contributions: The current case study was conceived and designed by DK, VK. Procedure was performed by DK. Literature search was conducted by DK, VK. Manuscript was written by DK, VK. All authors have read and approved of the final manuscript.
Conflict of Interest: The authors have no conflict of interest to declare.
Financial Disclosure: The authors declared that this study has received no financial support.
(1.) Bucher P, Gervaz P, Morel P. Long-term results of radical resection for locally advanced duodenal adenocarcinoma. Hepatogastroenterology 2005; 52(66): 1727-9.
(2.) Cloyd JM, George E, Visser B. Duodenal adenocarcinoma: Advances in diagnosis and surgical management. World J Gastrointest Surg 2016; 8(3): 212-21. [CrossRef]
(3.) Sakamoto T, Saiura A, Ono Y, Mise Y, Inoue Y, Ishizawa T, et al. Optimal Lymphadenectomy for Duodenal Adenocarcinoma: Does the Number Alone Matter? Ann Surg Oncol 2017; 24(11): 3368-75.
Daniel Kostov [iD], Vasil Kostov [iD]
Cite this article as: Kostov D, Kostov V. Primary Duodenal Adenocarcinoma. Erciyes Med J 2019; 41(1): 117-8.
Department of Surgery, Naval Hospital, Military Medical Academy, Varna, Bulgaria
Available Online Date 27.12.2018
Daniel Kostov, Department of Surgery, Naval Hospital, Military Medical Academy, Varna, Bulgaria
Phone: +359 888954829
|Printer friendly Cite/link Email Feedback|
|Author:||Kostov, Daniel; Kostov, Vasil|
|Publication:||Erciyes Medical Journal|
|Article Type:||Case study|
|Date:||Mar 1, 2019|
|Previous Article:||Lung Adenocarcinoma Presented with Extensive Pulmonary Calcification.|
|Next Article:||Severe Varicella Pneumonia in an Immunocompetent Adult.|