Presentation
Chronic epigastric pain, vomiting, and weight loss.
Patient Data
There is an irregular circumferential thickening of the 3rd/4th parts of the duodenum (length =8 cm), extending to the 1st jejunal loop with heterogeneous enhancement following IV contrast and mild distension of the proximal duodenum. There is an obliteration of the periduodenal/duodenopancreatic fat plane with no pancreatic involvement on sagittal reconstruction. The tumor is in contact with the infrarenal aorta with partial vascular encasement of the superior/inferior mesenteric arteries, and inferior mesenteric vein. Small peritumoural lymphadenopathies are noted.
The liver shows a small hypodense nodule (7 mm) in segment II (confirmed by ultrasound as a simple hepatic cyst).
Case Discussion
CT features of a malignant duodenal tumor, pathologically proven as adenocarcinoma.