J Korean Soc Radiol.  2018 Aug;79(2):92-96. 10.3348/jksr.2018.79.2.92.

Adenosquamous Carcinoma of Duodenal Bulb Mimicking Subepithelial Tumor on Computed Tomography: A Case Report

• Sim H
• Woo JY
• Yang I
• Hwang JY
• Moon JH
• Kim HM
• Kim HY
• Kim HJ
• Hwang SM
• Kim JW
• Hwang JW

• KMID: 2416394
• DOI: http://doi.org/10.3348/jksr.2018.79.2.92

Abstract

Adenosquamous carcinomas of the duodenum are extremely rare neoplasms in which both glandular and squamous elements demonstrate malignant characteristics. Few cases of adenosquamous carcinoma involving the second or third segment of the duodenum have been reported in the literature. Herein, we report the first case of adenosquamous carcinoma of the bulb of the duodenum that mimicked subepithelial tumor on computed tomography in a 59-year-old man.

MeSH Terms

Carcinoma, Adenosquamous*
Duodenum
Humans
Middle Aged
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 A 59-year-old man with adenosquamous carcinoma involving duodenal bulb. A. Upper gastrointestinal endoscopy reveals a subepithelial mass at duodenal bulb and spurting bleeding on the surface of the mass (left), and epinephrine injection is done for hemostasis (right). B. Axial and coronal images of contrast enhanced CT scan show a 3 cm sized well-circumscribed hypoattenuating mass surrounded by hyperattenuating duodenal wall at the bulb of duodenum (arrows). The lesion causes gastric outlet obstruction. C. Grossly, a well-defined solid mass shows granular, necrotic, and hemorrhagic cut surface involves the duodenal wall. D. Microscopically, the lesion displays glands with intracellular mucin (black arrow) and islands with intercellular bridges and keratin pearl typical of squamous differentiation (white arrow) (hematoxylin and eosin stain, × 100). E. Immunohistochemically, the glandular part is immunoreactive for cytokeratin 7 (× 200). F. The squamous part is positive for p40 (× 200).

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