Pathological diagnosis and clinical feature analysis of descending duodenal mucosal adenocarcinoma: A case report.

IF 1.8 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY World Journal of Gastrointestinal Surgery Pub Date : 2024-12-27 DOI:10.4240/wjgs.v16.i12.3862
Jin-Yuan Zhang, Liu-Sheng Wu, Jun Yan, Qiang Jiang, Xiao-Qiang Li
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Abstract

Background: Mucosal adenocarcinoma of the descending duodenum is a very rare gastrointestinal tumor. Due to its low incidence, it has rarely been the focus of clinical and pathological studies. The clinical manifestations of these tumors are usually nonspecific, and they are easily misdiagnosed or missed. Pathological diagnosis is the gold standard for diagnosis, but due to the small number of cases, the relevant pathological characteristics and diagnostic criteria are not completely clear. The purpose of this study was to deepen the understanding of the diagnosis and treatment of this disease and to provide a clinical guidance.

Case summary: A 61-year-old woman who was hospitalized with recurrent abdominal pain for more than 20 days. The patient developed epigastric pain with no obvious cause more than 20 days prior, mainly left epigastric pain and middle epigastric pain, and presented persistent dull pain without nausea or vomiting, fever or chills. The patient was treated at a local hospital, gastroscopy revealed a new lesion in the circum-intestinal cavity in the descending part of the duodenum, and pathological biopsy revealed mucous adenocarcinoma in the descending part of the duodenum. Currently, for further diagnosis and treatment, the patient is admitted to our hospital for surgical treatment for "malignant tumor of the duodenum" in the outpatient department.

Conclusion: Mucosal adenocarcinoma of the descending duodenum has a high misdiagnosis rate and missed diagnosis rate, clinical manifestations lack specificity, and pathological diagnosis is the main basis for diagnosis.

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十二指肠降黏膜腺癌病理诊断及临床特征分析1例。
背景:十二指肠降部粘膜腺癌是一种非常罕见的胃肠道肿瘤。由于其发病率低,很少成为临床和病理研究的重点。这些肿瘤的临床表现通常是非特异性的,容易误诊或漏诊。病理诊断是诊断的金标准,但由于病例较少,相关病理特征及诊断标准尚不完全明确。本研究旨在加深对本病诊治的认识,为临床提供指导。病例总结:一名61岁女性,因复发性腹痛住院20多天。患者于20多天前无明显原因出现上腹疼痛,以左、中上腹疼痛为主,表现为持续性钝痛,无恶心呕吐、发热、寒战。患者于当地医院就诊,胃镜检查示十二指肠降段肠腔周围新病灶,病理活检示十二指肠降段粘液腺癌。目前,为进一步诊治,患者在门诊以“十二指肠恶性肿瘤”住院接受手术治疗。结论:十二指肠降段粘膜腺癌的误诊率和漏诊率较高,临床表现缺乏特异性,病理诊断是诊断的主要依据。
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