早期十二指腸癌の1例―症例報告と本邦報告例の検討

Early Carcinoma of the Duodenum, Report of a Case and Review of the Literature in Japan

要旨　原発性十二指腸癌は比較的まれな疾患で，早期のものは少数の報告をみるにすぎない．今回，われわれは十二指腸下行部に発生した早期癌の1例を経験したので，本邦報告例の集計を併せて報告した．患者は55歳男性で，無症状であったが胃集検により要精検とされ，寺田病院を受診した．上部消化管透視，内視鏡検査により，十二指腸下行部に約5cm大の隆起性病変が指摘された．膵頭十二指腸切除が行われ，乳頭上部に47×35×22mm大の亜有茎性ポリープがみられ，表面顆粒状で潰瘍形成はみられなかった．病理組織学的には腺腫の一部に，乳頭状腺管腺癌（sm）がみられ，リンパ節転移はみられなかった．

　A 55 year-old man was admitted to Terada Hospital because of an abnormality detected in the mass screening program for gastric cancer. Upper gastrointestinal series had showed the elevated lesion, about 5 cm in diameter in the second portion of the duodenum. Endoscopically it was polypoid and semipedunculated. Pancreaticoduodenectomy and lymph node dissection were performed. Gross appearance of the resected specimen showed a polypoid lesion, measuring 47×35×24 mm in size. The surface of the lesion was granular without ulceration. Histologically papillotubular adenocarcinoma was found in adenoma located whithin the mucosa and submucosa. Lymph nodes were intact from metastasis. This was the 36 th case of the early duodenal carcinoma re-ported ever in Japan. The results of the literature review was also reported.