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World J Gastroenterol. Jul 7, 2010; 16(25): 3206-3210
Published online Jul 7, 2010. doi: 10.3748/wjg.v16.i25.3206
Published online Jul 7, 2010. doi: 10.3748/wjg.v16.i25.3206
Annular pancreas associated with duodenal carcinoma
Enrico Brönnimann, Daniel Oertli, Oleg Heizmann, Department of Surgery, University of Basel, CH-4031 Basel, Switzerland
Silke Potthast, Institute of Diagnostic Radiology, University Hospital Basel, CH-4031 Basel, Switzerland
Tatjana Vlajnic, Institute of Pathology, University of Basel, CH-4031 Basel, Switzerland
Author contributions: Heizmann O, Oertli D and Brönnimann E designed the research and performed the surgical operation; Potthast S performed the radiological analysis; Vlajnic T performed the pathological analysis; Potthast S and Oertli D contributed to writing the paper; Brönnimann E and Heizmann O analyzed the data and wrote the paper.
Correspondence to: Enrico Brönnimann, MD, Department of Surgery, University of Basel, CH-4031 Basel, Switzerland. broennimannen@uhbs.ch
Telephone: +41-61-2652525 Fax: +41-61-2657250
Received: January 25, 2010
Revised: March 19, 2010
Accepted: March 26, 2010
Published online: July 7, 2010
Revised: March 19, 2010
Accepted: March 26, 2010
Published online: July 7, 2010
Abstract
Annular pancreas (AP) is a rare congenital anomaly. Coexisting malignancy has been reported only in a few cases. We report what is, to the best of our knowledge, the first case in the English literature of duodenal adenocarcinoma in a patient with AP. In a 55-year old woman with duodenal outlet stenosis magnetic resonance cholangiopancreatography showed an aberrant pancreatic duct encircling the duodenum. Duodenojejunostomy was performed. Eight weeks later she presented with painless jaundice. Duodenopancreatectomy revealed a duodenal adenocarcinoma, surrounded by an incomplete AP. Thus, co-existent malignancy with AP can be present without obstructive jaundice and without being visible through preoperative diagnostics.