| [ Summary ] |
We describe the clinical aspects of advanced duodenal carcinoma, including metastatic carcinoma, presenting our own experience with cases. Primary duodenal carcinoma is comparatively rare, occurring mostly in men in their sixties, and presenting with symptoms such as upper abdominal pain, anemia and weight loss. Most duodenal carcinomas arise in the descending part of the duodenum in the form of a Borrmann 2 type tumor, and are histopathologically differentiated. When tumor size exceeds 5cm in diameter, food passage is frequently disturbed. Moreover, moderately and poorly differentiated carcinomas really metastasize to distant organs. Treatment should be carefully planned, based on optimal utilization of all imaging diagnostic modalities because of the anatomical complexity in proximity to the duodenum. The curative resection rate and the 5-year survival rate have both been increasing recently. However, it is essential to further improve both rates, and this will necessitate early detection of duodenal carciioma. Though most metastatic carcinomas are derived from the direct infiltration of pancreatic carcinoma, malignant invasion from other digestive organs around the duodenum and metastatic carcinoma from distant organs should be also considered. |