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A Case of Early Gastric Cancer Prolapsed into the Duodenal Bulb M. Noguchi 1 , R. Miyasaki 1 , Y. Furukawa 1 , H. Watanabe 1 , T. Katayama 1 11st. Department of Internal Medicine, Tokyo Medical and Dental University pp.1563-1567
Published Date 1971/11/25
DOI https://doi.org/10.11477/mf.1403111449
  • Abstract
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 A 66-year-old woman visited our hospital for the routine physical examinaton and was found to have a tumor in the duodenal bulb by x-ray examination. Radiologically the tumor was round, 3cm in diameter, with irregular margins. The filling defect appeared to be a pedunculated mass with its base possibly originating from the pyloric ring. The turnor could not be returned to the stomach by manipulation.

 Gastroscopic examination revealed an irregular epithelium, but the tumor was not identified.

 Duodenalfiberscope also failed to demonstrate the mass, but when the scope was retracted into the gastric space, a part of the tumor was visualized. A diagnosis of adenocarcinoma was made on the basis of biopsy specimen from the lesion. On operation, the tumor was pedunculated on a broad, short stalk which was located in the prepyloric region.

 Pathological diagnosis was adenocarcinoma tubulare localized in the mucosal layer of a part of the tumor.

 When a filling defect is found in the duodenal bulb, a differential diagnosis between a bulbar tumor and a stomach polypoid lesion prolapsed into the bulb is essential. The present case exemplifies difficulties in this differential diagnostic problem.


Copyright © 1971, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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