Duodenal Tumours

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DEFINITION

Duodenal Tumours
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EPIDEMIOLOGY

Uncommon.
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AETIOLOGY

Benign

Brunner gland adenomas
- small, submucosal, post D1/D2 wal.
- can bleed or obstruct

Villous adenomas
- high risk of malignant change (50%)

Carcinoid
- often metabolically active in D, e.g. gastric, somatostatin or serotonin.

Malignant

Adenocarcinoma

Leiomyosarcoma / GIST

Lymphoma

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BIOLOGICAL BEHAVIOUR

Natural history
Malignancies
Tend to be in D4
After curative resection, 5-yr survival is only 30%
- allcomers = only 18%.

Complications
Obstruction
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MANIFESTATIONS

Symptoms
Pain, bleeding, obstruction jaundice.

Signs
Perhaps a mass.

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INVESTIGATIONS

Endoscopy
And biopsy.
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MANAGEMENT

Medical
RadioRx if unresectable.

Operative
Resect when possible.
Pacncreaticoduodenectomy generally, if localized.

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REFERENCES
Doherty

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