Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2017; 23(4): 730-734
Published online Jan 28, 2017. doi: 10.3748/wjg.v23.i4.730
Real case of primitive embryonal duodenal carcinoma in a young man
Julien Barbieux, Riccardo Memeo, Vito De Blasi, Sebastian Suciu, Vanina Faucher, Gerlinde Averous, Catherine Roy, Jacques Marescaux, Didier Mutter, Patrick Pessaux
Julien Barbieux, Riccardo Memeo, Vito De Blasi, Jacques Marescaux, Didier Mutter, Patrick Pessaux, Hepato-Biliary and Pancreatic Surgical Unit, IRCAD-IHU, University of Strasbourg, Place de l’Hôpital, 67091 Strasbourg, France
Sebastian Suciu, Department of Gastroenterology, NHC, University of Strasbourg, Place de l’Hôpital, 67091 Strasbourg, France
Vanina Faucher, Catherine Roy, Department of Radiology, NHC, University of Strasbourg, Place de l’Hôpital, 67091 Strasbourg, France
Gerlinde Averous, Department of Pathology, NHC, University of Strasbourg, Place de l’Hôpital, 67091 Strasbourg, France
Author contributions: Barbieux J, Memeo R, De Blasi V, Suciu S, Marescaux J, Mutter D and Pessaux P designed and wrote the paper; Faucher V and Roy C analysed the MRI and CT; Averous G performed the histological analysis.
Institutional review board statement: Not necessary in France for one report.
Informed consent statement: The patient provided informed consent.
Conflict-of-interest statement: All authors declare no conflict of interest related to this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Riccardo Memeo, Head of Hepato-Biliary and Pancreatic Surgery Department, Hepato-Biliary and Pancreatic Surgical Unit, IRCAD-IHU, University of Strasbourg, Place de l’Hôpital, 67091 Strasbourg, France. drmemeo@yahoo.it
Telephone: +33-3-69550553 Fax: +33-3-69551741
Received: July 7, 2016
Peer-review started: July 11, 2016
First decision: July 29, 2016
Revised: August 5, 2016
Accepted: September 14, 2016
Article in press: September 14, 2016
Published online: January 28, 2017
Processing time: 195 Days and 18.8 Hours
Abstract

We report here the case of a young man suffering from a rare germ cell tumour. The patient was a 25-year-old man who was referred to our centre for asthenia, stinging epigastric pain, and an iron deficiency anaemia. Gastroscopy revealed a circumferential vegetating lesion on the second portion of the duodenum. The lesion was indurated at the third portion of the duodenum, responsible for a tight stenosis. A computerized tomography-scan of the chest, abdomen and pelvis, and a pancreatic MRI showed a circumferential lesion with a bi-ductal dilatation (i.e., of the common bile duct and Wirsung’s duct) without metastatic localisation. The patient underwent a pancreaticoduodenectomy with lymph node dissection including all cellular adipose tissues of the hepatic pedicle from the hepatic common artery and of the retroportal lamina. Histological findings were suggestive of a duodenal embryonal carcinoma with pancreatic infiltration. This is the second published case highlighting the duodenal primitive localisation of an embryonal carcinoma with pancreatic infiltration.

Keywords: Embryonal carcinoma; Germ cell tumour; Duodenum; Young male; Pancreaticoduodenectomy

Core tip: Duodenal embryonal carcinoma is a rare germ cell localisation. This lesion may be revealed by a chronic or acute haemorrhage. Our patient presented with an iron deficiency anaemia associated with asthenia and epigastric pain. Imaging studies and endoscopy showed a tight stenosis of the third portion of the duodenum with a circumferential lesion responsible for a common bile duct and Wirsung’s duct dilatation without any metastatic localisation. The patient underwent a pancreaticoduodenectomy and histological findings helped to identify a duodenal embryonal carcinoma with pancreatic infiltration.