[Malignant duodenal neoplasia: clinical-pathological profile]

The main purpose of the study was to learn about the clinical-pathological profile of the malignant duodenal neoplasia in our country. To that effect, a descriptive and prospective study was performed, involving the examination of 25 cases diagnosed between April 2000 and March 2002 in the Department of Digestive System Diseases of the "Edgardo Rebagliati Martins" National Hospital (Lima-Peru). Malignant duodenal neoplasia accounted for 1.6% of malignant gastro-intestinal neoplasias, with 86.2% endoscopic - histologic correlation. The average age was 64.9 years, with predominance of males (64%). The average period of the symptoms until diagnosis was reached, was of 6.2 months, the most frequent being: weight loss (84%) paleness (84%) abdominal pain (64%) and hyporexia (60%). The obstructive picture prevailed in the inframpullary lesions, high digestive hemorrhage in the suprampullary lesions and obstructive jaundice in the periampullary lesions. Metastases was evident in 64.7% of primary malignant neoplasias. The most frequent type of lesion was mixed (40%) prevailing the proliferative-ulcerated type and most had a suprampullary location (44%). The most frequent histological variation was the adenocarcinoma (52%) followed by metastatic lesions (32%), lymphoma (12%) and carcinoid tumor (4%). The treatment administered was merely supportive in 14 cases (56%), palliative in seven cases (28%) and curative in three cases (12%). Global survival by the end of the six months was of 12.5%.

Malignant duodenal neoplasia is an unusual incident, with delayed and non-specific clinical symptoms and it is therefore diagnosed in advanced stages. A curative treatment is seldom possible, hence global survival after six months is very low.