Treatment of Nonampullary Sporadic Duodenal Adenomas with Endoscopic Mucosal Resection or Ablation

Excerpt

Malignant neoplasms of the small intestine are rare; US annual incidence and mortality are 8,810 and 1,170, respectively [1]. Duodenal adenocarcinoma is even rarer, accounting for <0.5 % of all gastrointestinal malignancies but up to ~60 % of all small bowel cancers [2]. One proposed mechanism of duodenal carcinogenesis invokes the adenoma–carcinoma sequence, analogous to colorectal adenocarcinoma. Duodenal adenomas, regarded as potential premalignant lesions, are prevalent among patients with familial adenomatous polyposis, but sporadic adenomas among the general population are uncommon [3]. Given concern over malignant transformation, the traditional standard of care has been radical surgical excision. Nevertheless, surgery is associated with significant perioperative mortality and morbidity, lengthy hospital courses, and long-term complications, which diminish the quality and quantity of life [4]. Endoscopic intervention is a promising alternative therapeutic option. …