Abstract

The incidence of duodenal cancers is very low and reaches 0,3% of all cancers of gastrointestinal tract. In the literature only few reports have appeared on neoplasms situated above the papilla. A case is described of duodenal bulb cancer in a female aged 61 years. The only clinical manifestation was bleeding causing coffee ground vomiting and tarry stools. The diagnosis was made by endoscopy of the upper gastrointestinal tract showing a big (3,5i5i2 cm) exophytic lesion. Histological examination of biopsy material showed features of tubulo-villous adenoma with low grade dysplasia. Partial duodenectomy was performed including the lesion, and partial gastrectomy by the BII method. Microscopic examination of surgical specimen disclosed presence of adenocarcinoma. The presently reported case is, probably, the first duodenal bulb cancer described in Poland. It shows that the possibility of malignant process developing in the duodenal bulb should not be overlooked, although the duodenum is regarded usually as 'cancer free'. The result of the pre-surgery examination is not decisive as for the assesment of the state of the disease.

Keywords: Adenocarcinoma, Duodenum, Polyp