Abstract
A 77-year-old man was referred to our hospital for the management of a superficial nonampullary duodenal epithelial tumor. Duodenoscopy showed a 20-mm whitish flat elevated lesion above a subepithelial lesion (A). Magnifying endoscopy with narrow-band imaging showed a regular microsurface and microvascular pattern and diffuse white opaque substances on the surface within a demarcation line (B). EUS showed a low-echoic lesion in the second sonolayer. We diagnosed tubular adenoma overlying Brunner’s gland hyperplasia, and we performed endoscopic submucosal dissection for the purpose of en bloc resection (C).
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