Author/Authors :
Nakai, Osamu Department of Surgery - Uji Tokushukai Medical Center - Uji - Kyoto , Japan , Takagishi, Tomoko Department of Surgery - Uji Tokushukai Medical Center - Uji - Kyoto , Japan , Niimi, Yuta Department of Surgery - Uji Tokushukai Medical Center - Uji - Kyoto , Japan , Matsuki, Goshi Department of Surgery - Uji Tokushukai Medical Center - Uji - Kyoto , Japan , Nagano, Shinta Department of Surgery - Uji Tokushukai Medical Center - Uji - Kyoto , Japan , Hinami, Junsuke Department of Surgery - Uji Tokushukai Medical Center - Uji - Kyoto , Japan , Kajiwara, Masaaki Department of Surgery - Uji Tokushukai Medical Center - Uji - Kyoto , Japan , Kaneko, Kiyoshi Department of Surgery - Uji Tokushukai Medical Center - Uji - Kyoto , Japan , Kubota, Yoshihiro Department of Surgery - Uji Tokushukai Medical Center - Uji - Kyoto , Japan
Abstract :
Treatment of duodenal malignant lymphoma is difficult due to life-threatening complications such as intestinal obstruction,perforation, and pancreatitis. *us, multidisciplinary procedures are required alongside surgical intervention. Contrast ab-dominal CT images of a 75-year-old female suffering from vomiting revealed thickening of the duodenal wall (from the second tothird segment). Gastrojejunostomy and biopsy identified the tumor as diffuse large B-cell lymphoma. A diagnosis of stage IIduodenal lymphoma was made. *e lymphoma continued to grow, resulting in jaundice and intestinal perforation, which was firsttreated with two cycles of rituximab and antibiotics. *ereafter, less intensive chemotherapy (two cycles each of R-mini-CHP,CHP, and R-CHOP) was administered, which led to significant improvement upon assessment by PET-CT. Residual lymphomawas treated with consolidation radiotherapy (50 Gy in 25 fractions) over 5 weeks after chemotherapy. *e patient attaineda complete response and has been disease-free for more than 4 years. *us, duodenal perforated lymphoma can be treatedsuccessfully using a multidisciplinary approach that combines surgery, immunochemotherapy, and radiation therapy.
Keywords :
Successful Use , Multidisciplinary Approach , Treat aPerforated Duodenal Malignant Lymphoma , Elderly Patient