Online ISSN: 2515-8260

A Rare case of Poorly Differentiated Adenocarcinoma (Signet Ring Cell type) of Duodenum- Nonampullary Region: A Case Report

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1Raj Kumar Gupta, 2Banshidhar Soni, 3Taneesha Gupta

Abstract

Signet Ring Cell type Adenocarcinoma (SRCC) of Duodenum is a rare pathological entity to occur and most of these tumors which have been reported in surgical literature known to occur in ampullary region of second part of duodenum. These are extremely rare to occur in non-ampullary regions of duodenum and only few cases have been reported in English literature so far across the world. We are submitting a rare case report of an elderly lady who presented to our institution with clinical profile consistent with gastric outlet obstruction. An esophagogastroduodenoscopy revealed a circumferential growth at D1-D2 junction with deep ulcer. Histopathological examination from biopsied specimen revealed poorly differentiated adenocarcinomaSignet Ring cell type. On CT imaging she was found to have localized resectable disease and subsequently underwent standard Whipple’s pancreaticoduodenectomy. She had uneventful post-operative recovery. Final Histopathology confirmed poorly differentiated adenocarcinoma -signet ring cell type. We conclude that SRCC nonampullary region remains extremely rare entity. These tumors are usually diagnosed with advanced disease on presentation and can be managed well with surgical resection, by Whipples Pancreaticoduodenectomy in majority, which are localized

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