Duodenal adenocarcinoma

Case contributed by Dr Michael P Hartung

Presentation

Abdominal pain.

Patient Data

Gender: Male
CT

Circumferential irregular enhancing mass involving the second portion of the duodenum. Mild surrounding stranding. Mild porta hepatis adenopathy. No liver metastases. 

Case Discussion

EGD biopsy confirmed duodenal adenocarcinoma

This case highlights the importance of recognizing features that should raise concern for malignancy, and also those that might trick you into suggestion inflammation. Specifically, the degree of wall thickening, irregularity, and enhancement is highly concerning for tumor. The surrounding stranding could indicate an inflammatory or ulcerative component, but should not mislead you into suggesting this is a primarily inflammatory condition (such as peptic ulcer disease or duodenitis). 

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