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We describe a patient in whom an early carcinoma of the duodenum was able to be resected endoscopically. A 77-year-old man presented with epigastric pain. Upper gastrointestinal endoscopy revealed a mass in the duodenum, and the patient was admitted. A whitish nodular aggregated lesion, measuring 20 mm in diameter, was found in the second portion of the duodenum. Examination of a biopsy specimen showed a Group III tubular adenoma. Endoscopic ultrasonography showed that the lesion was confined to the mucosa. The large size of the lesion suggested the possibility of malignancy. Endoscopic mucosal resection was therefore performed. Histopathologically, the diagnosis was carcinoma in adenoma. The depth of invasion was mucosal. We conclude that endoscopic muosal resection can be used to treat mucosal lesions arising in the duodenum.
Tada et al. (1999) studied this question.