Abstract

CORREIA, Tito; ALMEIDA, Nuno; OLIVEIRA, Ana  and  SOFIA, Carlos. Primary adenocarcinoma of the third portion of the duodenum with concomitante identification of GIST of the jejunum: case report. J Port Gastrenterol. [online]. 2014, vol.21, n.1, pp.26-30. ISSN 0872-8178.  https://doi.org/10.1016/j.jpg.2013.11.001.

The authors present a 71 years-old male with epigastric and peri-umbilical pain for about 8 months, and more recent nausea, postprandial bloating and weight loss. Analytic investigation revealed ferropenic anemia and upper gastrointestinal endoscopies (2) were inconclusive. Given clinical worsening it was decided to repeat EGD with duodenal deep progression. In fact, in the transition from the 3 rd to the 4 th portion of the duodenum, a vegetating, circumferential and stenosing lesion was identified. Biopsies confirmed an adenocarcinoma and the patient underwent classic duodenopancreatectomy with removal of the duodenal lesion. Another lesion, localized in proximal jejuni, was identified and removed during the procedure. Histopathological study demonstrated that the later lesion was a gastrointestinal stromal tumor (GIST). This case demonstrates the diagnosis challenge of small bowel neoplasms given the nonspecific symptoms and common diagnosis delay. In this patient the presence of two distinct tumors seems to be an incidental finding.

Keywords : Duodenal adenocarcinoma; Gastrointestinal stromal tumor; Diagnosis.

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