Discussion This case report discusses a rare form of gastrointestinal tumor and its unique presentation in our patient. [dovepress.com]

Most of the clinical features are non-specific and include upper abdominal pain and weight loss as the most common presenting symptoms. [radiopaedia.org]

However, CIMP was associated with MSI in those studies, contrary to our present finding. [nature.com]

Two of these had had a palliative bypass at another institution before presenting at our institution. One patient died, for an overall in-hospital mortality of 1%. [jamanetwork.com]

Case presentation A 50-year-old woman presented to the Affiliated Hospital of Hebei University due to cough with sputum and shortness of breath after physical activities. [jgo.amegroups.com]

• Weight Loss

  Patients with duodenal cancer may experience abdominal pain, weight loss, nausea, vomiting, and chronic gastrointestinal bleeding. [en.wikipedia.org]

  A 79-year-old woman presented with refractory nausea, vomiting, and weight loss. EGD showed mucosal erythema and edema of the second part of the duodenum with lumen narrowing, leading to gastric outlet obstruction (GOO) (A). [giejournal.org]

  Metastatic nodal involvement, advanced tumor stage, and preoperative weight loss predict poorer patient survival but do not preclude cure. [jamanetwork.com]

  Most of the clinical features are non-specific and include upper abdominal pain and weight loss as the most common presenting symptoms. [radiopaedia.org]

• Familial Adenomatous Polyposis

  Laparoscopic pancreas-preserving total duodenectomy for familial adenomatous polyposis. Surg Laparosc Endosc Percutan Tech. 2011;21:e332–e335. [ncbi.nlm.nih.gov]

  Risk factors syndromic, e.g. familial adenomatous polyposis, Gardner syndrome, Lynch syndrome, Peutz-Jeghers syndrome 2,10 inflammatory, e.g. [radiopaedia.org]

  Familial adenomatous polyposis (FAP), Gardner syndrome, Lynch syndrome, Muir–Torre syndrome, celiac disease, Peutz–Jeghers syndrome, Crohn's disease and juvenile polyposis syndrome are risk factors for developing this cancer.[1] The duodenum is the first [en.wikipedia.org]

  Health conditions include: Cystic fibrosis Familial adenomatous polyposis (FAP) Peutz-Jeghers syndrome (PJS) MUTYH-associated polyposis Lynch syndrome Diet. [webmd.com]

  Inherited diseases: Certain genetic disorders increase your risk of duodenal cancer, including familial adenomatous polyposis (FAP), Lynch syndrome and cystic fibrosis. [my.clevelandclinic.org]

• Anemia

  Your doctor also may order a blood test since small intestine cancer can lead to anemia, or low red blood cells. You could also get a blood chemistry test to see how your organs are working. [webmd.com]

  Baseline blood investigations showed anemia, normal blood sugar level, liver function tests, renal function tests, and serology. [dovepress.com]

  Anemia, gastrointestinal obstruction and jaundice are symptoms associated with advanced disease. Abdominal pain is the most common presenting symptom, associated with 56% of cases[16]. [ncbi.nlm.nih.gov]

• Surgical Procedure

  As a result, patients are misdiagnosed or diagnosed at a late stage of the disease, by which time, resection of the tumor becomes incompatible with the scale of invasion and metastasis.6 Even though the optimal surgical procedure remains controversial [dovepress.com]

  If a negative resection margin can be secured, the type of surgical procedure appears of lesser importance in distal duodenal cancers, because neither segmental nor radical resection can remove the draining nodal basin. [jamanetwork.com]

• Asymptomatic

  The patient has been followed up for 11 years and remains asymptomatic and recurrence-free. A surveillance program was implemented with gastroscopies, double-balloon enteroscopies, two capsule endoscopy studies, and seven colonoscopies. [scielo.isciii.es]

• Vomiting

  Patients with duodenal cancer may experience abdominal pain, weight loss, nausea, vomiting, and chronic gastrointestinal bleeding. [en.wikipedia.org]

  A 79-year-old woman presented with refractory nausea, vomiting, and weight loss. EGD showed mucosal erythema and edema of the second part of the duodenum with lumen narrowing, leading to gastric outlet obstruction (GOO) (A). [giejournal.org]

  As cancer progresses, you may have constipation, abdominal pain, nausea or vomiting. Treatment options may include surgery, chemotherapy or radiation therapy. [my.clevelandclinic.org]

  This was not associated with abdominal distension, nausea or vomiting, and her bowel habits were normal. There was no history of fever, melena, hematemesis, and jaundice. [dovepress.com]

  Symptoms may include: Pain in your stomach Nausea and vomiting Dark stools (from blood in the intestine) Tiredness Weakness Weight loss As the cancer gets worse, other symptoms may include: Anemia. [webmd.com]

• Abdominal Pain

  Most of the clinical features are non-specific and include upper abdominal pain and weight loss as the most common presenting symptoms. [radiopaedia.org]

  As cancer progresses, you may have constipation, abdominal pain, nausea or vomiting. Treatment options may include surgery, chemotherapy or radiation therapy. [my.clevelandclinic.org]

  Patients with duodenal cancer may experience abdominal pain, weight loss, nausea, vomiting, and chronic gastrointestinal bleeding. [en.wikipedia.org]

  Case report A 38-year-old male with a previous diagnosis of PJS was hospitalized in another center for nausea, vomiting, and abdominal pain. [scielo.isciii.es]

  These include patients with Familial Adenomatous Polyposis, Crohn’s disease, Celiac disease, Peutz-Jeghers syndrome, and Hereditary Non-Polyposis Colorectal Cancer.8,10 In the study by Dabaja et al, abdominal pain and intestinal obstruction were by far [dovepress.com]

• Abdominal Distension

  This was not associated with abdominal distension, nausea or vomiting, and her bowel habits were normal. There was no history of fever, melena, hematemesis, and jaundice. [dovepress.com]

• Abdominal Cramps

  If the intestinal tumor grows, you may have symptoms that affect your digestive system, such as nausea, constipation or abdominal cramps. What is the duodenum? The duodenum is a small, horseshoe-shaped part of your small intestine. [my.clevelandclinic.org]

• Ulcer

  Peptic ulcer disease. American College of Gastroenterology website. Available at: http://patients.gi.org/topics/peptic-ulcer-disease. Accessed April 29, 2013. Peptic ulcer disease. EBSCO DynaMed website. [cancercarewny.com]

  […] out other causes.4 CECT must be performed in all biopsy-confirmed cases to stage cancer, determine its resectability, and plan necessary intervention.2,5 Malignant lesions typically appear as an exophytic or intramural mass with central necrosis and ulceration [dovepress.com]

  The production and characterization of monoclonal antibodies to a human colonic antigen associated with ulcerative colitis: Cellular localization of the antigen by using the monoclonal antibody. J. Immunol. 139, 77–84 (1987). [nature.com]

  In cases without a confirmed diagnosis, sensitive but non-specific radiographic features suggestive of malignancy include an exophytic or intramural mass, central necrosis and ulceration[19]. [ncbi.nlm.nih.gov]

Trastuzumab was used in combination with XELOX as the first line treatment and was used with PD1 inhibitors as the second line treatment. [jgo.amegroups.com]

Data of non-surgical palliative treatment were scarce. [ncbi.nlm.nih.gov]

Management and Treatment How is duodenal cancer treated? Your treatment plan varies depending on the cancer stage. [my.clevelandclinic.org]

Treatment[edit] Resection is sometimes a part of a treatment plan,[2] but duodenal cancer is difficult to remove surgically because of the area that it resides in—there are many blood vessels supplying the lower body. [en.wikipedia.org]

Metastasis, poor tumor differentiation, increased depth of spread and pre-existing Crohn's disease are associated with poor prognosis. Recurrence of the tumor is also a common entity. [radiopaedia.org]

Interestingly, intestinal type DA has been associated with more favorable prognosis compared to other histological subtype[22-24]. [ncbi.nlm.nih.gov]

Systematic review of microsatellite instability and colorectal cancer prognosis. J. Clin. Oncol. 23, 609–618 (2005). Article CAS PubMed Google Scholar Polom, K. et al. [nature.com]

Outlook / Prognosis What is the outlook for duodenal cancer? In general, the outlook for cancer is better when you detect it in early stages. It can be harder to treat if you find duodenal cancer in later stages. [my.clevelandclinic.org]

Most PDA originate in the second part of the duodenum, followed by the third, fourth, and first part with an incidence of 50–75%, 14–33%, 5–17%, and 1–15% respectively.7 The etiology of PDA has not been clearly identified, but certain groups of people [dovepress.com]

All of them had tumors in the periampullary region; their treatment was similar to patients without a predisposing etiology. Dr Aranha also asked about our management of villous adenomas. [jamanetwork.com]

Epidemiology of cancer of the small intestine. World J Gastrointest Oncol. 2011;3(3):33. doi:10.4251/wjgo.v3.i3.33 9. Curado MP, Edwards B, Shin HR, et al. Cancer Incidence in Five Continents. Vol. IX. [dovepress.com]

Epidemiology Small bowel malignancies are relatively rare, accounting for only 2% of all gastrointestinal cancers in the United States[4]. [ncbi.nlm.nih.gov]

The epidemiology and pathogenesis of neoplasia in the small intestine. Ann. Epidemiol. 19, 58–69 (2009). Article PubMed PubMed Central Google Scholar Cloyd, J. M., George, E. & Visser, B. C. [nature.com]

Prevention How can I prevent duodenal cancer? There’s no guaranteed way to prevent duodenal cancer. [my.clevelandclinic.org]

Being as lean as you can be may help prevent all kinds of cancers. Aim for 30 minutes of moderate exercise such as brisk walking every day. Consider surgery. [webmd.com]