Abstract
We herein report a rare occurrence of duodenal cancer arising from the remaining duodenum after pylorus-preserving pancreatoduodenectomy for ampullary cancer in familial adenomatous polyposis (FAP). In this patient, proctocolectomy and ileoanal anastomosis for FAP had been performed 11 years earlier. During the current admission, the patient was diagnosed with adenocarcinoma in the Vater’s ampulla using imaging and pathological examinations. In addition, a pylorus-preserving pancreatoduodenectomy was performed. The tumor was a well-differentiated tubular adenocarcinoma and no other polyps were identified in the duodenum by pathological examination. However, 1 year after surgery, a polypoid lesion measuring 15 * 15 mm was indicated in the remaining duodenum by endoscopic surveillance. This lesion was completely resected by endoscopic mucosal resection and the resected specimen revealed well-differentiated tubular adenocarcinoma in an adenomatous lesion. This report suggests that resection of the total duodenum is essential for duodenal neoplasms in FAP to prevent a recurrence in the remaining duodenum.
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References
Spigelman AD, Talbot IC, Penna C, et al. Evidence for adenomacarcinoma sequence in the duodenum of patients with familial adenomatous polyposis. The Leeds Castle Polyposis Group (Upper Gastrointestinal Committee). J Clin Pathol 1994;47:709–710.
Vasen HF, Bulow S, Myrhoj T, et al. Decision analysis in the management of duodenal adenomatosis in familial adenomatous polyposis. Gut 1997;40:716–719.
Jagelman DG, DeCosse JJ, Bussey HJ. Upper gastrointestinal cancer in familial adenomatous polyposis. Lancet 1988;1:1149–1151.
Arvanitis ML, Jagelman DG, Fazio VW, et al. Mortality in patients with familial adenomatous polyposis. Dis Colon Rectum 1990;33:639–642.
Penna C, Bataille N, Balladur P, et al. Surgical treatment of severe duodenal polyposis in familial adenomatous polyposis. Br J Surg 1998;85:665–668.
Farnell MB, Sakorafas GH, Sarr MG, et al. Villous tumors of the duodenum: reappraisal of local vs. extended resection. J GASTROINTEST SURG 2000;4:13–23.
Iwama T, Mishima Y, Utsunomiya J. The impact of familial adenomatous polyposis on the tumorigenesis and mortality at the several organs. Its rational treatment. Ann Surg 1993; 217:101–108.
Debinski HS, Trojan J, Nugent KP, et al. Effect of sulindac on small polyps in familial adenomatous polyposis. Lancet 1995;345:855–856.
Ruo L, Coit DG, Brennan MF, et al. Long-term follow-up of patients with familial adenomatous polyposis undergoing pancreaticoduodenal surgery. J Gastrointest Surg 2002;6:671–675.
Causeret S, Francois Y, Griot JB, et al. Prophylactic pancreaticoduodenectomy for premalignant duodenal polyposis in familial adenomatous polyposis. Int J Colorectal Dis 1998; 13:39–42.
Cameron JL, Pitt HA, Yeo CJ, et al. One hundred and forty five consecutive pancreaticoduodenectomies without mortality. Ann Surg 1993;217:430–438.
Spigelman AD, Williams CB, Talbot IC, et al. Upper gastrointestinal cancer in patients with familial adenomatous polyposis. Lancet 1989;2:783–785.
Spigelman AD, Granowska M, Phillips RK. Duodeno-gastric reflux and gastric adenomas: a scintigraphic study in patients with familial adenomatous polyposis. J R Soc Med 1991; 84:476–478.
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Murakami, Y., Uemura, K., Sasaki, M. et al. Duodenal cancer arising from the remaining duodenum after pylorus-preserving pancreatoduodenectomy for ampullary cancer in familial adenomatous polyposis. J Gastrointest Surg 9, 389–392 (2005). https://doi.org/10.1016/j.gassur.2004.07.010
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DOI: https://doi.org/10.1016/j.gassur.2004.07.010