Papillary carcinoma of the duodenum combined with right renal carcinoma: a case report

Xuan Zhang ,Shouwang Cai ,Zhen Zhou ,Jiahong Dong

doi:10.1186/1477-7819-11-30

Xuan Zhang , Shouwang Cai + Show 2 more

Open Access

https://doi.org/10.1186/1477-7819-11-30

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Abstract

We report a case of papillary carcinoma of the duodenum combined with right renal carcinoma. A 58-year-old man underwent a physical examination that revealed intrahepatic and extrahepatic bile duct dilatation on B ultrasound. Intrahepatic bile duct dilatation could be seen on magnetic resonance imaging (MRI), but the head of the pancreas and distal bile duct showed no tumor signals, which led to a diagnosis of periampullary carcinoma and right renal carcinoma. Considering the trauma of pancreaticoduodenectomy combined with renal resection operation is greater, we carried out the laparoscopic right renal radical resection first, and then a pylorus-preserving pancreaticoduodenectomy was performed. However, postoperative intra-abdominal infections and bleeding occurred; our patient improved after vascular interventional microcoil embolization for the treatment of hemostasis. The second operation for celiac necrotic tissue elimination, jejunal fistulization and peritoneal lavage and drainage was performed 14 days latter. Our patient improved gradually and was discharged on the 58th postoperative day. There has been no tumor recurrence after a follow-up of 26 months.

Highlights

Duodenal papilla carcinoma is classified as a periampullary carcinoma
Intrahepatic bile duct dilatation could be seen on the magnetic resonance imaging (MRI) scan, but the head of the pancreas and distal bile duct showed no tumor signals leading to a diagnosis of periampullary carcinoma and right renal carcinoma
Considering the trauma of pancreaticoduodenectomy combined with renal resection operation is greater, and laparoscopic resection of renal tumors is feasible with fast recovery, after weighing the risks of endoscopic retrograde cholangiopancreatography (ERCP) we carried out the laparoscopic right renal radical resection first without carrying out ERCP

Summary

Introduction

Duodenal papilla carcinoma is classified as a periampullary carcinoma. Its early diagnosis is difficult because of the lesion site. There have been no previous reports of cases of duodenal papilla carcinoma combined with right renal carcinoma. Our patient was found to have intrahepatic and extrahepatic bile duct dilatation on B ultrasound without other symptoms initially, and was hospitalized for further examination and treatment. Case presentation A 58-year-old man was found to have intrahepatic and extrahepatic bile duct dilatation on B ultrasound on 12 June 2009, and was hospitalized for further examination and treatment on 20 June 2009.

Results

Conclusion