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September 12, 2025Open Access

Underwater traction-assisted endoscopic submucosal dissection of a neuroendocrine tumor in the duodenal bulb

Key Points

Traction-assisted endoscopic submucosal dissection successfully treated a neuroendocrine tumor in the duodenal bulb.
A 15-mm subepithelial lesion was confirmed as a neuroendocrine tumor via fine-needle biopsy using a 22G Trident needle.
An endoscopic ultrasound identified characteristics of the tumor, supporting the diagnosis and treatment plan.
This approach may improve outcomes and offers an innovative method for managing duodenal neuroendocrine tumors.

Abstract

A 68-year-old man with a 15-mm subepithelial lesion (SEL) on the anteroinferior wall of the duodenal bulb, just distal to the pylorus (Fig. 1 a) was referred for further management. An endoscopic ultrasound (EUS) was performed, which identified a 15-mm oval-shaped, hypoechoic, submucosal lesion, with a finely inhomogeneous echostructure and peripheral vascular signals. Fine-needle biopsy (FNB) with a 22G Trident needle (Micro-Tech, Nanjing, China) confirmed the diagnosis of a neuroendocrine tumor (NET).

Underwater traction-assisted endoscopic submucosal dissection of a neuroendocrine tumor in the duodenal bulb

Key Points

Abstract

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