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Vol. 3, No. 1, 2009
Issue release date: January – April
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Case Rep Gastroenterol 2009;3:49–55
(DOI:10.1159/000212992)
Published: April 2009

Duodenal Signet Ring Cell Carcinoma in a Celiac Patient

Pisello F.a · Geraci G.a, b · Li Volsi F.a · Stassi F.a · Modica G.a · Sciumè C.a, b
aSection of General and Thoracic Surgery and bService of Surgical Endoscopy, University of Palermo, Palermo, Italy

Abstract

Celiac disease results from damage to the small intestinal mucosa due to an inappropriate immune response to a cereal protein. Long-standing or ‘refractory’ celiac disease is associated with an increased risk of autoimmunity and malignancy. We produced a brief literature review starting from a case of duodenal cancer in a celiac patient. The patient with an history of celiac disease since six months presented with acute manifestation of gastric outlet syndrome. A duodenal stricture was diagnosed at upper gastrointestinal endoscopy and confirmed by abdominal computed tomography. He was successfully treated by segmental duodenal resection. In the resected specimens, the diagnosis was duodenal signet cell adenocarcinoma. 6-month follow-up is uneventful. Primary carcinoma of the duodenum is rare (duodenal adenocarcinoma accounts for less than 0.5% of all gastrointestinal cancers and 30–45% of small intestinal cancers). Some patients with duodenal carcinoma are potentially curable by surgery, but conflicting opinions exist on the factors influencing the survival rate and on surgical treatment as the gold standard. Nevertheless, the goal in surgical treatment is to achieve clear margins. At present, surgical resection (pancreaticoduodenectomy or pancreas-sparing duodenal segmental resection) is the only available option for cure of this disease.

 goto top of outline Author Contacts

Girolamo Geraci, MD
Via Carmelo Trasselli, 16
IT–90129 Palermo (Italy)
Tel. +39 3 382 406 671, Fax +39 091 657 1728, E-Mail ggeraci@unipa.it


 goto top of outline Article Information

Published online: April 10, 2009
Number of Print Pages : 7
Number of Figures : 4,


 goto top of outline Publication Details

Case Reports in Gastroenterology

Vol. 3, No. 1, Year 2009 (Cover Date: January - April)

Journal Editor: Urrutia R. (Rochester, Minn.)
ISSN: NIL (Print), eISSN: 1662-0631 (Online)

For additional information: http://www.karger.com/CRG


Open Access License / Drug Dosage

Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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