下部直腸癌と併存した十二指腸下行脚の広範な表面型腺腫の１例

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  • A Case of Superficial Widespread Tumor of the Duodenal Second Portion with Lower Rectal Carcinoma

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A 69-year-old man reporting melena and difficulty in bowel evacuato was admitted under a diagnosis of rectal carcinoma. Preoperative gastroendoscopy showed a surficial widespread tumor of the duodenal second portion located on the anal side of the papilla of Vater. Endoscopic biopsy showed that the tumor was tubullovillous adenoma with severe atypia. Endoscopic ultrasonography showed that the tumors were localized within the mucosal layer. No other tumors were seen aside from those in the rectum and duodenum. We conducted low anterior resection for rectal carcinoma, incised the duodenum, and undertook ring-shaped partial resection of the duodenum for the duodenal tumor. Histopathological examination of resected material showed the duodenal tumor to be tubullovillous adenoma with severe atypia and rectal carcinoma to be welldifferentiated adenocarcinoma, depth ss, stage IIIb.

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