A 67-year-old woman with a 10-year history of cervical carcinoma treated with surgical
operation and external radiation therapy presented with abdominal pain, nausea, and
vomiting. On physical examination, the patient had epigastric tenderness. A contrast-enhanced
computed tomography scanning of the abdomen revealed a 20-cm-long asymmetric wall
thickening of both descending and horizontal parts of the duodenum with mural stratification
(Fig. 1A-B). Upper gastrointestinal endoscopy revealed merely swelling and diffuse mucosal
congestion along descending and horizontal portions of the duodenum instead of visible
duodenal masses (Fig. 1C). An initial biopsy was performed. Histology confirmed tumor cell infiltration of
the duodenal mucosa (Fig. 1D, hematoxylin-eosin stain). Immunohistochemical staining for cervical squamous carcinoma
markers demonstrated tumor cells diffusely positive for CK7 (Fig. 2A), CK5/6 (Figure 2B), P40 (Fig. 2C), and P63 (Fig. 2D), thus diagnosing metastatic cervical cancer to the duodenum, which was further
defined by a high proliferation index Ki-67 around 90% in neoplastic cells (Fig. 2E). Targeted therapy combined with immunotherapy was started, but after initial clinical
response she developed hepatic, retroperitoneal and adrenal masses consistent with
metastases.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of the Medical SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Acute Gastrointestinal Bleeding: A Report of Rare Presentation of Duodenal Metastasis From Cervical Squamous Cell Carcinoma.Cureus. 2021; 13: e16245https://doi.org/10.7759/cureus.16245
- Duodenal metastasis of cervical adenosquamous carcinoma.Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2012; 10: A34https://doi.org/10.1016/j.cgh.2012.02.020
- Metastatic Cervical Cancer to the Duodenum: A Learning Point.Cureus. 2021; 13: e13874https://doi.org/10.7759/cureus.13874
Article Info
Publication History
Accepted:
September 21,
2022
Received:
June 25,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Declaration of Competing Interest
The authors have no conflicts of interest to declare.
Identification
Copyright
© 2022 Published by Elsevier Inc. on behalf of Southern Society for Clinical Investigation.
