Magnifying endoscopic findings of early duodenal adenocarcinoma in relation to the pathological findings.

tity, with an autopsy incidence reported to range from 0.02% to 0.12 % [1 ±3]. We recently experienced a case of early duo− denal adenocarcinoma, which we de− scribe here. We report the magnifying en− doscopic findings in relation to the histo− pathological findings. An 80−year−old man underwent upper endoscopy as part of a routine medical evaluation. This revealed a small elevated lesion in the duodenum opposite the su− perior duodenal angulus (l" Fig. 1 a). A vascular−rich lesion was found to exist on the duodenal mucosa. Dilated and irregu− lar villous structures were revealed by magnifying endoscopy (l" Fig. 1 b, c). Fur− ther magnification revealed the villous structures to have disappeared in the ir− regular lesion and dilated meandering vessels showing an unequal caliber were observed (l" Fig. 1 d). After submucosal injection of glycerol, the lesion was completely removed by an endoscopic resection without any complications. A histopathological examination revealed well−differentiated adenocarcinoma (5 ” 2 mm) arising from the duodenal mucosa. l" Fig. 2 compares the findings of magnifying endoscopy with the histo− logical findings. The magnifying endo− scopic findings which showed the villous structures to have disappeared with the presence of dilated meandering vessels correlated with cancer (l" Fig. 2, circle). The part with dilated villous structures was a nontumorous lesion (l" Fig. 2, box). The magnifying endoscopic findings correlated closely with the histological findings. Magnifying endoscopy may therefore be considered to be potentially useful in the diagnosis of early duodenal cancer.