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Gastric Cancer

, Volume 12, Issue 2, pp 118–122 | Cite as

Duodenal stump cancer after Billroth-II distal gastrectomy for gastric cancer

  • Junhyun Lee
  • Kyungji Lee
  • Wook Kim
Case Report

Abstract

Duodenal cancer is an uncommon neoplasm and it mostly arises from the periampullary area. However, metachronous or even recurrent cancer at the duodenal stump following Billroth II type distal gastrec tomy for gastric cancer is extremely rare and, to our knowledge, has not yet been reported. A 68-year-old man underwent Billroth II distal gastrectomy with D2 lymph node dissection for an advanced gastric cancer. At that time the tumor stage was T2bN3M0, with 44 of 78 retrieved lymph nodes showing metastasis. He was well without recurrence for 3 years; however, he visited our hospital because of the abrupt onset of dizziness and tarry stool. A polypoid tumor that bled easily when touched was found at the end of the afferent loop of the duodenal stump by gastrofiberscopic examination, and it was proven to be an adenocarcinoma by endoscopic biopsy. Fortunately, additional studies, including abdominal computed tomography and positron emission tomography-computed tomography, showed no other sites of recurrence. The patient underwent pancreaticoduodenectomy for local control of the recurrent tumor at the duodenal stump, and the pathologic findings, based on immunohistochemical staining, strongly suggested that the duodenal tumor was metachronous in nature rather than recurrent.

Key words

Advanced gastric cancer Recurrence Metachronous cancer Duodenal stump 

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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2009

Authors and Affiliations

  • Junhyun Lee
    • 1
  • Kyungji Lee
    • 2
  • Wook Kim
    • 1
  1. 1.Department of Surgery, Holy Family Hospital, College of MedicineThe Catholic University of KoreaBucheon, GyunggiKorea
  2. 2.Department of Hospital Pathology, Holy Family Hospital, College of MedicineThe Catholic University of KoreaBucheon, GyunggiKorea

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