duodenal cancer post-surgery

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Chengdu Puji Traditional Chinese Medicine Research Institute

Chengdu Puji TRADITIONAL CHINESE MEDICINE RESEARCH INSTITUTE Traditional Chinese Medicine Outpatient Department

Chengdu Puji

Traditional Chinese medicine case of tumor recovery

Kindness and skillfulness

V differential diagnosis and treatment according to symptoms and signs V treat the root cause and symptoms simultaneously survive with tumor

Clinical summary:

Diagnosis: duodenal cancer post-surgery Age: 61 Gender: male

61-year-old patient with duodenal cancer post-surgery [PATIENT]

Recheck in February 2025 showed a large lymph node at the root of the mesentery

lymph node about 13mm, larger lymph nodes in abdomen and pelvis about 11.1mm,

Visited our hospital in early 2026.

Suzhou North People's Hospital, Jiangsu Province

PET/CT report form

Name:

[REDACTED]

Age: 60 years old

Examination number: [REDACTED]

Department: Oncology 6B

Medical record number:

[REDACTED]

Examination item: PET/CT (combined)

Imaging agent: ''F-FDG

Hospital admission number:

[REDACTED]

The patient had fasted for more than 6 hours, intravenous injection of [P-FDG] 6.16 mCi followed by quiet rest for about 60 min; after urination, supine position

Duodenal malignant tumor

then perform PET/CT tomographic imaging. Computer reconstruction obtained fused PET and CT images. No intravenous or oral contrast agents were used during the examination.

Imaging findings:

under fasting condition, intravenous injection of "F-FDG, rest quietly, after urination, lie supine for whole-body PET and CT tomographic imaging, calculate

three-dimensional fusion image obtained by reconstruction, image displayed clearly.

liver background SUVmax is 2.03, mediastinal pool SUVmax is 1.37.

intrahepatic biliary dilation. gallbladder not clearly visualized. fat space at mesenteric root blurred, multiple lymph nodes show mild abnormal uptake

main lesion observation:

post-pancreaticoduodenectomy, level corresponding to third part of duodenum and pancreatic head, pancreatic head region shows intestinal convergence, wall slightly thickened, common bile duct not clearly visualized,

increased, the largest lesion with short diameter approximately 13mm,

SUVmax is 1.84. diffuse thickening of peritoneum in abdomen and pelvis with multiple nodular formations, radiographic

uptake abnormally increased, predominantly in the anterior thigh region

8.3mm, SUVmax is 5.05, uptake remains high after delayed imaging, SUVmax is 6.97; intestinal gas and dilation in abdomen and pelvis, primarily

(level corresponding to L4 vertebra)nodular lesion tightly adjacent to anterior abdominal wall, the larger lesion measuring approximately 1.1X

prominent in rectum, sigmoid colon, descending colon, partial intestinal wall in pelvis suspicious for thickening with abnormal increased uptake, SUVmax is 6.03,

after delayed imaging, distended sigmoid colon gas discharged, local intestinal wall still thickened, uptake further increased, SUVmax is 12.19;

head and neck:

+ pressure distribution uniform, bilateral frontal, parietal, temporal, and occipital lobes showing radiographic distribution

after patient's medication, re-examination conducted on March 2026, no lymph node detected at the root of mesentery, diagnosis

section shows partial lesion disappearance compared to previous examination, partial lesions showing shrinkage compared to prior size.

Suzhou North People's Hospital, Jiangsu Province

PET/CT report form

examination date: 2026-03-17

name: [PATIENT]

gender: male

examination item: PET/CT (combined)

medical record number:

[REDACTED]

clinical diagnosis: malignant tumor of duodenum

tracer: 18F-FDG

Examination number: [REDACTED]

room: tumor day

hospitalization number:

[REDACTED]. computer reconstruction obtained fused PET and CT images. examination did not use intravenous or oral

The patient had fasted for more than 6 hours, with a blood glucose level of 5.9 mmol/L: intravenous injection of 18F-FDG 34 mCi followed by quiet rest for about 60 min; excretion

contrast agent.

Imaging findings:

Postoperative malignant tumor of the duodenum; duodenum and pancreatic head are absent, small intestine is aggregated in the pancreatic head area with thickened walls, and shows increased radioactivity uptake

Liver background SUVmax is 2.50, mediastinal blood pool SUVmax is 1.62.

abnormal increased radioactivity uptake. Multiple small lymph nodes are seen in the peritoneal and retroperitoneal areas

mildly increased, SUVmax of head? 91

bile duct imaging is unclear, pancreatic duct dilation, no residual pancreas seen

high, largest measuring approximately 10.9×8.6 mm, SUVmax of head 16

not seen in CIIV,

Partial mild abnormal increased radioactivity uptake

Pelvic area shows small amount of fluid shadow. Residual stomach is poorly distended, and surgical area is seen,

x is 1.68; slight thickening of the peritoneum in the abdominal and pelvic areas

high-density anastomotic clip shadow, thickened gastric wall with increased radioactivity uptake, SUVmax is 3.43. The rest of the intestinal tubes show uneven radioactivity uptake

4.00, delayed imaging, partial intestinal morphology changes,

increased, especially in the pelvic small intestine, SUVmax is 4.79, thickened intestinal wall with abnormal increased radioactivity uptake, SUVmax is

6.86, rectal SUVmax is 4.91, multiple dilated and gas-filled intestinal tubes in the abdominal and pelvic areas, with some showing gas-liquid levels. Calcification is seen in the left abdominal region

Abnormal increased radioactivity uptake in the ileocolic and ileal regions, SUVmax is

nodular lesions.

1. Postoperative malignant tumor of the duodenum; multiple small lymph nodes in the peritoneal and retroperitoneal areas, with mild increased glucose metabolism in some

Diagnostic impression:

high, slight thickening of the peritoneum in the abdominal and pelvic areas, no significant glucose metabolism, slight fluid accumulation in the pelvis, written on 2025.02.14 PB1/CT comparison, partial

one new finding of hydronephrosis involving the entire ureter

Lesions have largely disappeared compared to previous findings, with partial lesions showing slight reduction and decreased metabolism,

thickened, glucose metabolism is not elevated; please correlate with clinical and MRI examination results, cystoscopy: hepatic glucose metabolism is uneven

wall of the contralateral ureter is thickened, nodular lesions at the bladder posterior wall (at the bilateral ureteral entry points)

uniformly with suspicious focal increased glucose metabolism; recommend correlation with clinical findings, enhanced CT, or VRI examination.

Thickened small intestine walls in the pancreatic head area, with mild increase in glucose metabolism; increased glucose metabolism in the ileocolic and ileal regions, pelvic small intestine

2. Increased wall thickness and abnormal glucose metabolism in the esophageal wall, more pronounced in the mid-to-upper segments, thickened gastric wall with increased glucose metabolism, and

fluid accumulation, with some showing gas-liquid levels; please correlate with clinical and endoscopic examination.

Increased glucose metabolism, suggestive of inflammatory etiology; thickened rectal wall with increased glucose metabolism, multiple dilated and gas-filled intestinal tubes in the abdominal and pelvic regions