Seven cases of primary carcinoma of the duodenum *
Primary carcinoma of the duodenum is rare compared with gastric or colorectal cancer and it is also a type of cancer for which it is difficult to make a preoperative diagnosis because it has no specific symptoms. In the last eight years, we treated seven cases (male 6, female 1) of primary carcinoma of the duodenum. Their mean age was 61 years old. As for the initial symptoms, three cases had epigastric pain, one case had jaundice and three cases were asymptomatic. Endoscopy and hypotonic duodenography were useful for the preoperative diagnosis in these cases. The tumors were located in the suprapapillary region in two cases, and in the infrapapillary region in five cases. All patients underwent surgery. Four cases underwent a pancreatoduodenectomy, two cases underwent local excision and one patient was unresectable. Histological examination revealed that six cases were well-differentiated adenocarcinomas, and one was a mucinous adenocarcinoma. Five of the seven patients had early stage duodenal cancer, resulting in a good prognosis. It is difficult to make an early diagnosis because carcinoma of the duodenum has no specific symptoms. Endoscopic screening of the second or third portion of the duodenum by gastroduodenoscopy would be useful to find early stage duodenal cancer. A precise preoperative diagnosis which determines the depth of cancer invasion is necessary for the choice of treatment. (Accepted on June 28, 2002) Kawasaki Igakkaishi 28 (3 ) : 137-142, 2002
