[A Case of Early Duodenal Cancer with Lymph Node Involvement Confirmed by Laparoscopic Lymph Node Sampling].

Abstract

The patient was a 67-year-old man. A Type 0-Ⅱa+Ⅱc tumor, 20mm in size was observed in the 1st portion of the duodenum under magnifying endoscopy. Mucosal cancer was suspected and endoscopic resection was performed, with pathological findings as follows: Type 0-Ⅱa+Ⅱc, 19×12 mm, tub1, pT1b(SM2: 700 mm), pUL0, Ly0, V0, pHM0, pVM0. He refused subtotal stomach-preserving pancreaticoduodenectomy(SSPPD)because of the high morbidity and mortality rates. Instead, he underwent only laparoscopic sampling of No. 5, 6, 12b, and 13a lymph nodes, and metastasis in a No. 6 node was pathologically confirmed. He eventually underwent SSPPD with D2, but no metastases were found in other lymph nodes. Pancreaticoduodenectomy is currently considered the best treatment option for complete removal of regional lymph nodes in duodenal cancer despite high morbidity and mortality rates. Further studies are needed to determine the pattern and incidence of lymph node metastasis by location and depth of the primary tumor, to establish optimal treatment guidelines for duodenal cancer.

• Authors: Yuzo Yamazato, Toshiyuki Kosuga, Takeshi Kubota, Kazuma Okamoto, Katsutoshi Shoda, Kenji Nanishi, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, Ryo Morimura, Hisashi Ikoma, Osamu Dohi, Hideyuki Konishi, Eigo Otsuji
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 45 Issue 13 Pg. 2144-2146 (Dec 2018) ISSN: 0385-0684 [Print] Japan
• PMID: 30692312 (Publication Type: Case Reports, Journal Article)

Topics

• Aged
• Duodenal Neoplasms (diagnosis, pathology, surgery)
• Humans
• Laparoscopy
• Lymph Node Excision
• Lymph Nodes
• Lymphatic Metastasis (diagnosis)
• Male
• Neoplasm Invasiveness