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Open Access 01-12-2016 | Case report

A case of carcinoma of the papilla of Vater in a young man after subtotal colectomy for familial adenomatous polyposis

Authors: Shuji Komori, Masahiko Kawai, Toyoo Nitta, Yusuke Murase, Keita Matsumoto, Chika Shinoda, Masashi Kuno, Yuki Sasaguri, Masahiro Fukada, Yoshimi Asano, Shigeru Kiyama, Chihiro Tanaka, Yasuko Nagao, Narutoshi Nagao, Katsuyuki Kunieda

Published in: World Journal of Surgical Oncology | Issue 1/2016

Abstract

Background

Carcinoma and adenoma of the duodenum, including the papilla of Vater, are problematic diseases in patients with familial adenomatous polyposis (FAP).

Case presentation

A 36-year-old man underwent a periodic medical examination for early colon cancer originating from FAP for which laparoscopic-assisted subtotal colectomy with a J-shaped ileal pouch-rectal anastomosis was performed 3 years earlier. A tumor was detected at the papilla of Vater along with elevation of total bilirubin and hepatobiliary enzymes. Although cytology did not determine the tumor to be an adenocarcinoma, we suspected adenocarcinoma due to its hypervascularity shown by contrast-enhanced computed tomography. Pylorus-preserving pancreaticoduodenectomy with modified Imanaga reconstruction and regional lymph node dissection (D2) was performed. The pathological study showed that the tumor was a papillary and moderately differentiated tubular adenocarcinoma. The patient is currently in good health without recurrence, weight loss, or severe diarrhea at 12 months after surgery.

Conclusions

Awareness of biliary-pancreatic symptoms and periodic gastroduodenoscopy might contribute both to the early detection of duodenal or periampullary polyps and cancer and to the radical treatment of FAP. Modified Imanaga reconstruction has the potential to become one of the more effective procedures for providing good quality of life to FAP patients with duodenal or periampullary cancer.

Bülow S, Björk J, Christensen IJ, Fausa O, Järvinen H, Moesgaard F, et al. Duodenal adenomatosis in familial adenomatous polyposis. Gut. 2004;53:381–6.PubMedCentralCrossRefPubMed

Nugent KP, Spigelman AD, Phillips RK. Life expectancy after colectomy and ileorectal anastomosis for familial adenomatous polyposis. Dis Colon Rectum. 1993;36:1059–62.CrossRefPubMed

Nakatsubo N, Kashiwagi H, Okumura M, Kamoshida T, Takahashi A, Spigelman AD. Malignant change in a duodenal adenoma in familial adenomatous polyposis: report of a case. Am J Gastroenterol. 1998;93:1566–8.PubMed

Spigelman AD, Talbot IC, Penna C, Nugent KP, Phillips RK, Costello C, et al. Evidence for adenoma-carcinoma sequence in the duodenum of patients with familial adenomatous polyposis. The Leeds Castle Polyposis Group (Upper Gastrointestinal Committee). J Clin Pathol. 1994;47:709–10.PubMedCentralCrossRefPubMed

Groves CJ, Saunders BP, Spigelman AD, Phillips RK. Duodenal cancer in patients with familial adenomatous polyposis (FAP): results of a 10 year prospective study. Gut. 2002;50:636–41.PubMedCentralCrossRefPubMed

Parc Y, Mabrut JY, Shields C, Mallorca Group. Surgical management of the duodenal manifestations of familial adenomatous polyposis. Br J Surg. 2011;98:480–4.CrossRefPubMed

Johnson MD, Mackey R, Brown N, Church J, Burke C, Walsh RM. Outcome based on management for duodenal adenomas: sporadic versus familial disease. J Gastrointest Surg. 2010;14:229–35.CrossRefPubMed

Skipworth JR, Morkane C, Raptis DA, Vyas S, Olde Damink SW, Imber CJ, et al. Pancreaticoduodenectomy for advanced duodenal and ampullary adenomatosis in familial adenomatous polyposis. HPB (Oxford). 2011;13:342–9.CrossRef

de Castro SM, van Eijck CH, Rutten JP, Dejong CH, van Goor H, Busch OR, et al. Pancreas-preserving total duodenectomy versus standard pancreatoduodenectomy for patients with familial adenomatous polyposis and polyps in the duodenum. Br J Surg. 2008;95:1380–6.CrossRefPubMed

10.

Wallace MH, Phillips RK. Upper gastrointestinal disease in patients with familial adenomatous polyposis. Br J Surg. 1998;85:742–50.CrossRefPubMed

11.

Kadmon M, Tandara A, Herfarth C. Duodenal adenomatosis in familial adenomatous polyposis coli. A review of the literature and results from the Heidelberg Polyposis Register. Int J Colorectal Dis. 2001;16:63–75.CrossRefPubMed

12.

van Heumen BW, Nieuwenhuis MH, van Goor H, Mathus-Vliegen LE, Dekker E, Gouma DJ, et al. Surgical management for advanced duodenal adenomatosis and duodenal cancer in Dutch patients with familial adenomatous polyposis: a nationwide retrospective cohort study. Surgery. 2012;151:681–90.CrossRefPubMed

13.

Yoon YS, Kim SW, Park SJ, Lee HS, Jang JY, Choi MG, et al. Clinicopathologic analysis of early ampullary cancers with a focus on the feasibility of ampullectomy. Ann Surg. 2005;242:92–100.PubMedCentralCrossRefPubMed

14.

Kawabata Y, Ishikawa N, Moriyama I, Tajima Y. What is an adequate surgical management for pTis and pT1 early ampullary carcinoma? Hepatogastroenterology. 2014;61:12–7.PubMed

15.

Seiler CA, Wagner M, Bachmann T, Redaelli CA, Schmied B, Uhl W, et al. Randomized clinical trial of pylorus-preserving duodenopancreatectomy versus classical Whipple resection-long term results. Br J Surg. 2005;92:547–56.CrossRefPubMed

16.

Karanicolas PJ, Davies E, Kunz R, Briel M, Koka HP, Payne DM, et al. The pylorus: take it or leave it? Systematic review and meta-analysis of pylorus-preserving versus standard whipple pancreaticoduodenectomy for pancreatic or periampullary cancer. Ann Surg Oncol. 2007;14:1825–34.CrossRefPubMed

17.

Tran KT, Smeenk HG, van Eijck CH, Kazemier G, Hop WC, Greve JW, et al. Pylorus preserving pancreaticoduodenectomy versus standard Whipple procedure: a prospective, randomized, multicenter analysis of 170 patients with pancreatic and periampullary tumors. Ann Surg. 2004;240:738–45.PubMedCentralCrossRefPubMed

18.

Ogata Y, Hishinuma S. The impact of pylorus-preserving pancreatoduodenectomy on surgical treatment for cancer of the pancreatic head. J Hepatobiliary Pancreat Surg. 2002;9:223–32.CrossRefPubMed

19.

Niedergethmann M, Shang E, Farag Soliman M, Saar J, Berisha S, Willeke F, et al. Early and enduring nutritional and functional results of pylorus preservation vs classic Whipple procedure for pancreatic cancer. Langenbecks Arch Surg. 2006;391:195–202.CrossRefPubMed

20.

Ohtsuka T, Tanaka M, Miyazaki K. Gastrointestinal function and quality of life after pylorus-preserving pancreatoduodenectomy. J Hepatobiliary Pancreat Surg. 2006;13:218–24.CrossRefPubMed

21.

Murakami Y, Uemura K, Sasaki M, Morifuji M, Hayashidani Y, Sudo T, et al. Duodenal cancer arising from the remaining duodenum after pylorus-preserving pancreatoduodenectomy for ampullary cancer in familial adenomatous polyposis. J Gastrointest Surg. 2005;9:389–92.CrossRefPubMed

22.

Kawai M, Tani M, Hirono S, Miyazawa M, Shimizu A, Uchiyama K, et al. Pylorus ring resection reduces delayed gastric emptying in patients undergoing pancreatoduodenectomy: a prospective, randomized, controlled trial of pylorus-resecting versus pylorus-preserving pancreatoduodenectomy. Ann Surg. 2011;253:495–501.CrossRefPubMed

23.

Kawai M, Tani M, Hirono S, Okada K, Miyazawa M, Yamaue H. Pylorus-resecting pancreaticoduodenectomy offers long-term outcomes similar to those of pylorus-preserving pancreaticoduodenectomy: results of a prospective study. World J Surg. 2014;38:1476–83.CrossRefPubMed

24.

Yang C, Wu HS, Chen XL, Wang CY, Gou SM, Xiao J, et al. Pylorus-preserving versus pylorus-resecting pancreaticoduodenectomy for periampullary and pancreatic carcinoma: a meta-analysis. PLoS One. 2014;9:e90316.PubMedCentralCrossRefPubMed

Title: A case of carcinoma of the papilla of Vater in a young man after subtotal colectomy for familial adenomatous polyposis
Authors: Shuji Komori
Masahiko Kawai
Toyoo Nitta
Yusuke Murase
Keita Matsumoto
Chika Shinoda
Masashi Kuno
Yuki Sasaguri
Masahiro Fukada
Yoshimi Asano
Shigeru Kiyama
Chihiro Tanaka
Yasuko Nagao
Narutoshi Nagao
Katsuyuki Kunieda
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2016
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/s12957-016-0806-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A case of carcinoma of the papilla of Vater in a young man after subtotal colectomy for familial adenomatous polyposis

Abstract

Background

Case presentation

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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