Cases reported "Duodenal Neoplasms"

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1/171. Coexisting carcinoid tumors in familial adenomatous polyposis-associated upper intestinal adenomas.

    Upper gastrointestinal polyps and extraintestinal tumors are well recognized in association with familial adenomatous polyposis (FAP). Although carcinoid tumors have been reported in association with sporadic colonic neoplasms and ulcerative colitis, to date, carcinoids have not been reported in association with FAP. We report a patient with FAP who has recurrent carcinoid tumors located at the bases of duodenal adenomas. The genetic basis of carcinoid neoplasms is still uncertain. This report may represent the clinical effect of the APC gene mutation on the enterochromaffin cell line manifesting as recurrent carcinoid tumors in physical association with intestinal adenomas. Future genetic analysis and epidemiological studies may be of value in determining whether a true association exists.
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2/171. Resection of triple synchronous cancers: a case report.

    We herein present a case of synchronous triple cancer, which was successfully resected in a curative manner. These cancers consisted of primary duodenal, pancreatic and lung cancers, which were diagnosed in an asymptomatic 74 year-old male, who was referred to our department on December 14, 1996. On admission, his laboratory data showed no abnormality, including tumor markers (CEA 1.0, CA 19-9 1.0, AFP 8.1 U/ml), but he did show an impaired pulmonary function (FEV1.0: 57%). Upper gastrointestinal endoscopy showed a smooth surfaced duodenal tumor measuring 4 cm in size. The second tumor was found at the head of the pancreas by computed tomography (CT), showing a hypervascular mass measuring 3.0 cm, along with neighboring multiple cysts. In endoscopic retrograde cholangiopancreatography (ERCP), marked mucous secretion was observed through the papilla, while a filling defect was found in the dilated pancreatic duct. In a routine chest X-ray, a third tumor, which measured 1.5 cm in diameter, was recognized in the right upper lobe of the lung, and a moderately differentiated squamous cell carcinoma was also detected by a percutaneous CT guided biopsy. The pancreatic and duodenal tumors were surgically resected by a pancreatoduodenectomy (Stage I) in January 1997 and, 5 months later, a lung tumor underwent partial resection (Stage I). This patient tolerated these surgical procedures well and presently leads a normal, healthy life after discharge. In summary, a successful resection of synchronous triple cancers, which has never been previously reported in this specific combination, is described.
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3/171. Duodenal somatostatinoma presenting as upper gastrointestinal bleeding.

    Duodenal somatostatinoma is a rare cause of upper gastrointestinal bleeding. We report the case of a 55-yr-old woman who presented with upper gastrointestinal hemorrhage due to a duodenal somatostatinoma. We discuss the characteristics of these tumors, and review the literature on diagnostic workup and management.
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4/171. Excessive nodular hyperplasia of brunner glands associated with gastric hypersecretion and lipomatous atrophy of the pancreas.

    The case of a 34-year-old woman complaining of diarrhoea and abdominal pain is presented. Contrast radiography and endoscopy showed multiple polypoid tumours in the second part of the duodenum. Moreover, a severe fatty infiltration of the pancreas was shown by magnetic resonance and computed tomography scans. Due to pain, pancreatoduodenectomy (Whipple operation) was performed, and subsequent histopathologic examinations showed excessive Brunner gland hyperplasia of the duodenum and severe lipomatous atrophy of the pancreas. The occurrence of these two rare conditions in one patient has not been described previously, and it is conceivable that the lipomatous atrophy and exocrine insufficiency of the pancreas may have caused a compensatory stimulation of the submucosal structures of the duodenum.
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keywords = abdominal pain
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5/171. Malabsorption with progressive weight loss and multiple intestinal ulcers in a patient with T-cell lymphoma.

    We describe a 52-year-old woman who presented with severe diarrhea, nausea, intermittent abdominal pain and weight loss of 18 kg within ten months. Jejunal and duodenal ulcers were detected by endoscopy and multiple biopsies revealed villous atrophy of the jejunum. However, neither gliadin nor endomysium antibodies were detected and no clinical and histological improvement was achieved after gluten withdrawal. Despite strong clinical suspicion for intestinal lymphoma many unrevealing biopsies were done. The patient developed intermittent septic fever and diagnostic laparotomy revealed jejunal perforation. Partial jejunal resection was performed and histology confirmed the diagnosis of an intestinal T-cell lymphoma without celiac disease. Malabsorption and all intestinal ulcers disappeared during the course of chemotherapy (six cycles CHOP) and the patient recovered remarkably.
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6/171. A Brunner's gland adenoma as a cause of anemia.

    Benign tumors of the small bowel are rare. They present with many different manifestations depending on the size and location, and also cause a variety of symptoms that are often nonspecific. These include abdominal pain, dyspepsia, nausea, vomiting, and gastrointestinal bleeding that may be melena or hematemesis. Most of the time patients are asymptomatic and the lesions are discovered as an incidental finding. When bleeding occurs, and it may be severe in certain situations, the patient may develop signs of anemia, such as dyspnea, fatigue, and even high-output cardiac failure. The authors present a patient who was evaluated for melena and who was found to have a duodenal polyp that proved to be a Brunner's gland adenoma on pathology.
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7/171. Duodenal metastasis from large cell carcinoma of the lung: report of a case.

    Duodenal metastasis from primary lung cancer is extremely rare. It rarely shows any symptoms, and the prognosis for this condition is poor. We herein describe the case of a 46-year-old woman with primary lung cancer who underwent a left upper lobectomy. Severe anemia was observed about 20 days after lobectomy. Gastroduodenoscopy showed duodenal metastasis. Simultaneously, brain metastasis was also detected using magnetic resonance imaging. The patient underwent a local resection of the duodenum and a tumor resection of the brain. Postoperative irradiation of the brain metastases and systemic chemotherapy of the lung metastases were performed, and complete remission occurred. However, abdominal lymph node metastasis recurred, and the patient died 1 year after the lobectomy.
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8/171. teratocarcinoma presenting with duodenal metastases diagnosed on endoscopic fine needle aspiration.

    Upper gastrointestinal bleed as the first symptom of metastatic testicular tumors is rare. We describe a 17-year-old man who presented with upper gastrointestinal bleed; endoscopic fine needle aspiration cytology from a duodenal mass suggested germ cell tumor, which was later confirmed on histology of the testis.
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9/171. Primary malignant fibrous histiocytoma of the duodenum.

    BACKGROUND/AIM: We report on a case of primary malignant fibrous histiocytoma of the duodenum. methods: Report of a case and review of the literature on the occurrence of this tumor in the alimentary tract. RESULTS: The neoplasm was detected incidentally at the time of diagnostic workup for upper gastrointestinal bleeding. Curative surgery using the Whipple procedure was carried out with uneventful postoperative course; no evidence of liver metastases was detected during intraoperative ultrasonography. The patient died of diffuse metastatic liver disease 2 months after surgical resection. Up-to-date review of the literature has added only 3 cases to those previously reported, including that reported by us. CONCLUSIONS: The biological behavior of malignat fibrous histiocytomas is extremely aggressive and mainly conditioned by size and histological grading. The treatment of choice, whenever possible, is based on early and complete surgical excision of the tumor. copyright copyright 1999 S. Karger AG, Basel
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10/171. Palliative transhepatic biliary drainage and enteral nutrition.

    Simultaneous intestinal and biliary obstruction is a rare but agonizing complication of metastatic abdominal cancer. Although endoscopic procedures exist that relieve jaundice or restore enteral nutrition, they can be impossible to perform for technical or anatomical reasons. We propose a palliative approach for these patients that includes transcutaneous common bile duct drainage, progressive dilation of the transhepatic channel over 1 wk, and, finally, insertion of a permanent silicon catheter that drains bile into the duodenum and is combined with an enteral feeding line. We report three patients whose metastatic abdominal tumors had led to simultaneous jaundice and gastric outlet obstruction, neither of which could be treated endoscopically. In all patients, the transcutaneous bile drainage catheter combined with the enteral feeding line was inserted and tumor symptoms resolved rapidly. As a result, the patients chose to return to home care with enteral nutrition and pain medication. The creation of a transhepatic access for simultaneous enteral bile drainage and nutrition is a technically simple procedure that causes little discomfort to a terminally ill patient. It relieves the symptoms of tumor obstruction, and the option of enteral nutrition and medication can obviate the need for intravenous infusions.
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keywords = discomfort
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