Poorly differentiated adenocarcinoma with signet-ring cells in ... | Adenocarcinoma poorly differentiated

Most duodenal papillary carcinomas (DPCs) are well differentiated [1]. Poorly differentiated DPCs are rare and have unfavorable prognosis.SkiptomaincontentAdvertisementSearchallSpringerOpenarticlesSearchDownloadPDFCaseReportOpenAccessPublished:17January2017Poorlydifferentiatedadenocarcinomawithsignet-ringcellsinduodenalpapilla:acasereportYutaUshida ORCID:orcid.org/0000-0003-3076-80131,KiyoshiHiramatsu1,SatomiSaeki1,TakeshiAmemiya1,HidenariGoto1&ToshiyukiArai1 SurgicalCaseReportsvolume 3,Article number: 14(2017)Citethisarticle1885Accesses1CitationsMetricsdetailsAbstractAn82-year-oldwomanwithcommonbileduct(CBD)dilatationobservedduringroutineultrasonographywasreferredtoourhospital.Preliminarybloodtestsrevealedelevatedlevelsofhepatobiliaryenzymes.Computedtomography(CT)scanshowedlowerbileductwallthickeningandenhancement.EsophagogastroduodenoscopyrevealedmildlyswollenpapillaofVater,withoutulceration.EndoscopicretrogradecholangiographydemonstratedthattheCBDwasgrosslydilatedwithaconstrictioninthelowerpart.Thefinaldiagnosisindicatedpoorlydifferentiatedadenocarcinomaofduodenalpapillawithsignet-ringcells;pT3N0M0,stageIIA(UnioInternationalisContraCancrum,7thedition),forwhichsubtotalstomach-preservingpancreaticoduodenectomy(SSPPD)wasperformed.Thiscaseisquiterare,andthesurgeryresultedinadesirableoutcome.Thepatienthasbeendisease-freefor5 yearssincethesurgery.BackgroundMostduodenalpapillarycarcinomas(DPCs)arewelldifferentiated[1].PoorlydifferentiatedDPCsarerareandhaveunfavorableprognosis.Signet-ringcellsintheduodenalpapillaareanindicationofpoorprognosis.Here,wereportacaseofpoorlydifferentiatedDPCwithsignet-ringcellsthathadfavorableoutcome.CasepresentationAn82-year-oldwomanwithcommonbileduct(CBD)dilatation,asobservedduringroutineultrasonography,wasreferredtoourhospital.Shewasasymptomatic.Laboratorytestresultswereaspartateaminotransferaselevel,278 IU/L;alanineaminotransferaselevel,184 IU/L;alkalinephosphataselevel,1877 IU/L;totalbilirubinlevel,0.42 mg/dL;amylaselevel,47 IU/L;andprese

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