The first documented case of duodenal carcinoma was described by Hamburger in 1746. Primary adeno-carcinoma of duodenum is rare. Malignant tumors of the small bowel are reported to account for about 1% of all gastrointestinal carcinoma. The autopsy incidence of duodenal adenocarcinoma is about 0.3% of all malignancy. The second and third portions of the duodenum are the usual sites of adenocarcinoma. Cancer in the duodenal bulb is exceedingly rare. Most of them revealed an intraluminal mass or wall thickening. But we have experienced a case of exophytic growth pattern adenocarcinoma such as the fistula of duodenal bulb in 49 year old male patient with hematemesis. For its great rarity, we report this case with review of literatures.
Adenocarcinoma* ; Autopsy ; Duodenum ; Fistula* ; Hematemesis ; Humans ; Incidence ; Male ; Middle Aged

Although neurologic complications of multiple myeloma are common, brain-involvement is rare, despite the high frequency of the cranial lesions. The cranial plasmacytoma grows only from bone, dura mater or adjacent mucous membrane and cerebral structures are affected secondarily. It is less likely that a solitary cranial plasmacytoma exists, and patients who harbor these neoplasms should undergo complete evaluations to exclude multiple myeloma. Solitary plasmacytoma is radiosensitive and the definite treatment for the cranial plasmacytoma usually consists of complete surgical resection with adjacent radiation therapy. However, the treatment and prognosis of the cranial plasmacytoma depends on whether this neoplasm is primary or secondary. Most of patients develop cranial plasmacytoma as the presenting form of multiple myeloma and the treamtment of in these speical cases is usually unsatisfatory. We report a case of multiple myeloma presented with the motor weakness of both upper and lower extremities by a bulky cranial plasmacytoma invading cerebrum treated with surgery, radiation therapy and chemotherapy.
Cerebrum* ; Drug Therapy ; Dura Mater ; Humans ; Lower Extremity ; Mucous Membrane ; Multiple Myeloma* ; Plasmacytoma* ; Prognosis