Abstract
A 64-year-old man underwent upper endoscopy as part of a routine medical evaluation, which revealed an elevated lesion in the duodenum opposite the major papilla (A; B, indigo carmine dye spraying). Double-contrast duodenography (C) demonstrated an elevated lesion with a central depression (arrow) in the second part of the duodenum. Endoscopic biopsy specimens revealed adenocarcinoma. The lesion was endoscopically resected en bloc; the 18×15-mm resection specimen included the 13×12-mm elevated lesion. Histopathologically, the cancer was a poorly differentiated carcinoma (D; H&E, orig. mag. ×10; ∗adenocarcinoma, ∗∗normal duodenal mucosa) with submucosal invasion. Pancreatoduodenectomy was performed. There was no evidence of residual cancer in the resection specimen or metastasis in resected lymph nodes. View Large Image Figure Viewer View Large Image Figure Viewer View Large Image Figure Viewer
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