# Robotic pancreatoduodenectomy for a giant duodenal leiomyoma: A case report and literature review

## TL;DR

A rare case of a large duodenal tumor was successfully treated with robotic surgery, suggesting minimally invasive options may be viable.

## Contribution

First reported use of robotic pancreatoduodenectomy for a giant duodenal leiomyoma.

## Key findings

- Robotic pancreatoduodenectomy was successfully used to treat a 6.5 cm duodenal leiomyoma.
- Minimally invasive surgery resulted in low blood loss and no recurrence after 7 months.
- This is the 19th reported case of surgically treated duodenal leiomyoma.

## Abstract

Duodenal leiomyomas are rare mesenchymal tumors. To date, several studies have reported on the safety and feasibility of surgical intervention for duodenal leiomyomas. However, minimally invasive surgery has rarely been performed in cases with duodenal leiomyomas. Herein, we present a case of a giant duodenal leiomyoma successfully treated with robotic pancreatoduodenectomy (RPD).

A 74-year-old man was referred to our hospital with a 6.5 cm duodenal tumor accompanied by gastrointestinal bleeding. The tumor was located in the second portion of the duodenum. Considering the tumor size and location, RPD was performed. Using the mesenteric Kocker maneuver, the posterior side of the duodenum was safely dissected, and the tumor was resected. The operative time was 373 min, with an estimated blood loss of 10 mL. The patient was followed up for 7 months with no recurrence.

To the best of our knowledge, this is the first to highlight the clinicopathological findings of a patient with duodenal leiomyoma undergoing RPD. To date, there have been 19 cases, including our case, reporting surgically treated duodenal leiomyoma. Treatment strategies should be decided depending on tumor characteristics, including the size, location, and histology of the tumor.

We present a rare case of a giant duodenal leiomyoma that was successfully treated with RPD. Minimally invasive surgery can be safe and an alternative for the treatment of large duodenal tumors.

•Duodenal leiomyomas are rare mesenchymal tumors.•We present a rare case of a giant duodenal leiomyoma that was successfully treated with robotic pancreatoduodenectomy.•Minimally invasive surgery can be safe and an alternative for the treatment of large duodenal tumors.

Duodenal leiomyomas are rare mesenchymal tumors.

We present a rare case of a giant duodenal leiomyoma that was successfully treated with robotic pancreatoduodenectomy.

Minimally invasive surgery can be safe and an alternative for the treatment of large duodenal tumors.