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

Introduction: Duodenal neoplasms are relatively rare entity, most often being cases of duodenal invasion by malignant masses developed in the duodenopancreatic region. The malignant infiltration of duodenum can be made either by a primary malignant duodenal tumor, either by invasion of a neighborhood malignancies, the most common being pancreatic cancer. The differentiation between these two malignant entities is absolutely necessary for the type of treatment chosen. Materials and methods: The paper comprises a retrospective study, which includes 147 patients admitted and treated in a period of 7 years, being analyzed the images and the examinations results performed during 2009-2015, which were confronted with surgery protocols, where applicable, or endoscopic explorations and histological examination results. Results: In the study group, 25 had been diagnosed with primary duodenal adenocarcinomas and the rest were pancreatic adenocarcinomas which invaded the duodenum. In terms of radioimaging , were analyzed the localization of tumors on the duodenal segment, the presence and the characteristics of lacunas and stenoses, the dimension of duodenal wall infiltrated by the tumor, and also the modifications of bile ducts. Conclusions: If endoscopy cannot be performed, radio-imaging exams remain the only methods that can guide the starting point of a malignant tumor in duodenopancreatic region. It is important to know whether the tumor has duodenal or pancreatic origin for establish therapeutic strategy, the survival rate being different.