Published online Jan 28, 2017. doi: 10.3748/wjg.v23.i4.730
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
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.
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.