Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2024; 16(12): 3862-3869
Published online Dec 27, 2024. doi: 10.4240/wjgs.v16.i12.3862
Pathological diagnosis and clinical feature analysis of descending duodenal mucosal adenocarcinoma: A case report
Jin-Yuan Zhang, Liu-Sheng Wu, Jun Yan, Qiang Jiang, Xiao-Qiang Li
Jin-Yuan Zhang, Xiao-Qiang Li, Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
Liu-Sheng Wu, Jun Yan, School of Medicine, Tsinghua University, Beijing 100084, China
Qiang Jiang, Department of Anorectal, Dazu District People’s Hospital, Chongqing 402360, China
Co-first authors: Jin-Yuan Zhang and Liu-Sheng Wu.
Co-corresponding authors: Qiang Jiang and Xiao-Qiang Li.
Author contributions: Wu LS wrote the manuscript; Zhang JY analysed the manuscript; Yan J collected the data; Li XQ and Jiang Q guided the study. Wu LS is responsible for the design of the entire research scheme, the conception of the research scheme and the writing of the manuscript; Zhang JY is responsible for the collation and analysis of the case literature and the follow-up of the case patients under the guidance of Wu LS’s research ideas. Therefore, Wu LS and Zhang JY have the same contribution. Jiang Q and Li XQ are the main persons in charge of this study. Li XQ organizes the discussion and analysis of this case and guides the relevant work; Jiang Q is responsible for supervising the progress of the whole research process and providing guidance and financial support. Li XQ and Jiang Q have made significant contributions to this study. All authors reviewed, edited, and approved the final manuscript and revised it critically for important intellectual content, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.
Supported by China Scholarship Council, No. 202406210298; the Scientific Research Project of the Education Department of Anhui Province, No. YJS20210324; the Research and Development of Intelligent Surgical Navigation and Operating System for Precise Liver Resection, No. 2022ZLA006; and the National Natural Science Foundation of China, No. 81972829.
Informed consent statement: This study has obtained informed consent and signed treatment consent from patients and their families.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Qiang Li, PhD, Professor, Department of Thoracic Surgery, Peking University Shenzhen Hospital, No. 1120 Lianhua Road, Futian District, Shenzhen 518036, Guangdong Province, China. dr.lixiaoqiang@gmail.com
Received: May 8, 2024
Revised: September 19, 2024
Accepted: October 18, 2024
Published online: December 27, 2024
Processing time: 203 Days and 1.4 Hours
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.

Keywords: Descending duodenal mucosal adenocarcinoma; Pathological diagnosis; Clinical features; Rare tumor; Case report

Core Tip: The pathological diagnosis and clinical features of a rare case of descending duodenal mucosa adenocarcinoma were analyzed. Through detailed pathological examination, we confirmed the histological type of the tumor, combined with the patient’s clinical manifestations, imaging findings and treatment response, and comprehensively analyzed the pathogenesis, progression and prognosis of the case. The research focuses on revealing the diagnostic difficulties and treatment challenges of such rare tumors, aiming to provide references for clinicians and improve the level of diagnosis and treatment of similar cases.