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Adenocarcinoma of the second portion of the duodenum – case report
Apresentação do caso
A 72-year-old white male patient from Pelotas/RS was referred with complaints of hematochezia, melena and weight loss (7kg in a month). The patient had associated comorbidities such as alcoholism, tobacco consumption and diabetes. Upper digestive endoscopy biopsy detected a well differentiated grade 1 adenocarcinoma in the second portion of the duodenum. Tumor staging by contrasted computed tomography of the thorax, abdomen and pelvis did not show any mass in the liver or retroperitoneal lymph nodes enlargement. After, it was found a 5 mm sessile polyp in the ascending colon during colonoscopy, and a polypectomy was performed. Duodenopancreatectomy with regional lymphadenectomy highlighted a 3 cm neoplasm in the second portion of the duodenum.
Around 1% to 10% of all malignant tumors affecting the digestive system are allocated in the small intestine, and only 0.35% is related to primary duodenum carcinomas. Its etiology is unknown, but patients with familial adenomatous polyposis, Lynch’s and von Recklinghausen’s syndromes, Crohn’s and celiac diseases have higher risk to develop a duodenal tumor. Related signals and symptoms of duodenum carcinomas are intestinal obstruction, weight loss and chronic digestive hemorrhage.
For second duodenum portion tumor cases, the duodenopancreatectomy with regional lymphadenectomy is a suitable procedure in curative surgical oncology.
Duodenum, adenocarcinoma, melena, weight loss
Trato gastrointestinal alto*
MARCO AURELIO VEIGA CONRADO, ANDRÉ LUIZ VEIGA CONRADO, PEDRO SANTOS GUIMARAES , RENAN BEZERRA RODRIGUES, LUCIANO NIEMEYER GOMES , CASSIO MELLO TEIXEIRA, AUGUSTO NOBRE KABKE, LUIS EUGENIO DE MEDEIROS COSTA, RICARDO LANZETTA HAACK