Diagnosis and management of duodenal adenocarcinomas: a comprehensive review for the radiologist

Abstract

Duodenal adenocarcinomas are the most common duodenal tumors, and represent 15-25% of small bowel carcinomas. Their management differs from other small bowel tumors, with imaging playing a very important role. In this article, we provide a comprehensive review of the diagnosis and management of duodenal adenocarcinomas, emphasizing the role of the radiologist in the same.

Malignant Duodenal Lesion - Duodenal Tumor Vs Pancreatic Tumor - Semiological Radioimaging Characteristics

“…Although they are considered to be very rare, there are studies that have shown that primary duodenal tumors are found in 15-25 % of cases of malignant tumors of the small intestine [5][6][7]. In the study group, primary duodenal malignant tumors were found in a number of 25 cases representing 17 % of all malignancies studied; in terms of pathology were adenocarcinomas.…”

Duodenal Bulb Adenocarcinoma Benefitted from Neoadjuvant Chemotherapy: A Case Report

“…Pancreaticoduodenectomy has an overall survival benefit according to some reports [1]. However, segmental resection is recommended for the horizontal and ascending duodenum because it has a reduced complication rate and achieves margin-negative resection [7]. Primary tumor and adequate regional lymph nodes should be completely resected during surgery.…”

“…Radical resection of distal stomach and duodenal bulb lesions is required for duodenal bulb adenocarcinoma close to the pyloric canal. As in the case of malignancy in the duodenal bulb with other involved parts or involvement of the descending part of the duodenum, pancreaticoduodenectomy is preferred [7]. Pancreaticoduodenectomy has an overall survival benefit according to some reports [1].…”

“…When endoscopy shows neoplasms or huge ulcers with or without surfaces covered with dirty fur, caution should be exercised for obtaining the proper positioning, depth, and number for adequate biopsy specimens. In addition, PET/CT or other advanced imaging modalities can help detect early disease [7]. If the definite diagnosis is not obtained by examinations, exploratory surgery with intraoperative frozen biopsy is a good choice.…”

“…Surgery is the most effective treatment modality for locoregional duodenal adenocarcinoma at present [7]. The site of the tumor, the extent of tumor progression, comorbidities, and patient performance conditions are considered preoperatively [5].…”