十二指腸早期癌の1例

Early Duodenal Cancer, Reporf of a Case

　X線，内視鏡診断学は目覚ましく進歩しているが，十二指腸癌は発見されたときには進行癌である場合が多く，早期に十二指腸癌を診断するのは非常に困難である．われわれは下十二指腸曲に発生した原発性早期十二指腸癌を経験したので報告する．

　A 45 year-old man, who had the left lower abdominal pain since a few years was seen with a complaint of tarry stool.

　Upper GI series showed the dilatation of the duodenum at the third portion. Hypotonic duodenography showed a nodular elevated lesion invaginating into the third portion of the duodenum from the inferior duodenal flexus. Duodenofiberscopy demonstrated the normal papilla vateri and a polypoid lesion at the infrapapillary part. The biopsy specimen revealed adenoma histologically.

　The partial duodenectomy was performed. Macroscopically, the tumor was papillary pedunculated polyp, 35×25×18 mm in size.

　Histologically the tumor was well-differentiated papillary adenocarcinoma and infiltrated into the core of the stalk.

　Early duodenal cancer is extremely rare. This case is the second report of early infrapapillary duodenal cancer in Japan.