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Early superficial non-ampullary duodenal tumors are particularly rare, the clinical manifestations, including typical endoscopic or imaging features, and treatment methods are not well-characterized. The present case report describes a case of an asymptomatic 74-year-old male who presented to the Taizhou People's Hospital (Taizhou, China) for a regular health screening, where a primary superficial non-ampullary duodenal tumor was identified. Upper endoscopy revealed ~1.2 cm lesion in the second portion of the duodenum. Chromoscopy and magnification endoscopy indicated an early cancer characteristic. Subsequent endoscopic submucosal dissection was performed to remove the lesion. Histopathology validated that the lesion was a high-grade intro-epithelial neoplasm without lymph node or blood vessel invasion.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5588043 | PMC |
http://dx.doi.org/10.3892/ol.2017.6576 | DOI Listing |
Introduction: Duodenal laparoscopic and endoscopic cooperative surgery (D-LECS) is a promising hybrid approach to managing duodenal neoplasia, including superficial non-ampullary duodenal epithelial tumors (SNADETs) and subepithelial lesions (SELs). This approach aims to reduce adverse events (AEs), such as delayed perforation, often associated with endoscopic submucosal dissection (ESD). Combining laparoscopic techniques for duodenal stabilization with precise endoscopic resection, D-LECS may provide safer and more comprehensive treatment.
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July 2025
Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan.
Background: Superficial non-ampullary duodenal epithelial tumors (SNADETs) were previously considered rare. However, the widespread use of health checkup endoscopy, improvements in endoscopic imaging and heightened awareness of SNADETs among endoscopists have recently led to an increase in their detection rate. Particularly for large SNADETs, the possibility of including cancer must be considered, and thus, complete and reliable resection is essential.
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July 2025
Molecular Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Background: Endoscopic resection (ER) is a minimally invasive alternative to surgical resection for superficial non-ampullary duodenal epithelial tumors (SNADETs); however, it carries a high risk of adverse events (AEs) due to the thin duodenal wall and the technical challenges of endoscopic maneuverability. This review discusses the management of intraoperative and delayed postoperative AEs associated with duodenal ER.
Summary: Various ER techniques for SNADETs, including cold snare polypectomy (CSP), endoscopic mucosal resection (EMR), underwater EMR (UEMR), and endoscopic submucosal dissection (ESD), present different risk profiles.
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July 2025
Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba, Japan.
Background: The recognition of superficial non-ampullary duodenal epithelial tumors (SNADETs) has increased with advancements in endoscopic technology and increased awareness among clinicians. White light imaging (WLI) remains the primary diagnostic modality for SNADETs. However, data for standardized endoscopic diagnostic approaches are lacking.
View Article and Find Full Text PDFObjectives: This study aimed to compare the short-term therapeutic outcomes between conventional endoscopic submucosal dissection (C-ESD) and gel immersion ESD (GI-ESD) for superficial non-ampullary duodenal epithelial tumors (SNADETs).
Methods: A retrospective analysis was conducted on patients with SNADETs who underwent C-ESD or GI-ESD between June 2016 and May 2024. To reduce proficiency bias, the first 50 cases per endoscopist were excluded.