Early carcinoma of the distal second part of the duodenum treated by wedgeresection

A case of early carcinoma of the distal second part of the duodenum, in a 7 4-year-old man, is presented. Endoscopic retrograde cholangiopancreatograph y was performed for diagnosis of a common bile duct stone. During this proc edure, small elevated lesions were found incidentally in the distal second part of the duodenum, and the histologic examination of a biopsy specimen s howed adenocarcinoma. The lesions were removed by wedge resection, and path ologic examination revealed duodenal carcinoma limited to the lamina propri a. Although carcinoma of the duodenum, other than of the ampulla of Vater r egion, is very rare, it is sometimes possible to detect asymptomatic early tumors. However, this requires careful observation of the entire duodenal m ucosa, including that of the distal duodenum,at duodenoscopy.