The online version of this article (doi:10.1186/1752-1947-6-280) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
HI is a doctor in private practice and he introduced the patient to the Department of Surgery at our hospital. KY is a professor in the Department of Surgery who arranged esophagogastroduodenoscopy for preoperative assessment. AD, KG, NY, KS, HT and SS have made substantial contributions to the acquisition and interpretation of clinical data. KG has been involved in drafting the manuscript or revising it critically for important intellectual content. MI provided and revised the pathological data. TK and HT have given final approval for the version to be published. All authors have read and approved the final manuscript.
Primary adenocarcinomas resembling submucosal tumors are rare in the gastrointestinal tract. Almost all the submucosal tumor-like adenocarcinomas previously reported invaded the submucosa or deeper. Therefore, submucosal tumor-like lesions are usually treated by surgical resection, and those that arise in the duodenum have been treated by pancreaticoduodenectomy.
A 65-year-old Japanese man was diagnosed with a submucosal tumor-like adenocarcinoma in his duodenum. We considered it possible that the tumor invasion was limited to the mucosal or submucosal layers and could be removed by endoscopic resection. Tumor histopathology revealed a well-differentiated adenocarcinoma confined to the muscularis mucosae with no lymphovascular invasion. Complete resection of the carcinoma was achieved and there has been no recurrence three years after endoscopic resection.
We suggest that submucosal tumor-like adenocarcinomas arising in nonampullary duodenal sites should be diagnosed carefully with a view to possible endoscopic resection.
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