title: Duodenal carcinoma at the ligament of Treitz. A molecular and clinical perspective.
abstract: BACKGROUND
  There is very small occurrence of adenocarcinoma in the small bowel. We present a case of primary duodenal adenocarcinoma and discuss the findings of the case diagnostic modalities, current knowledge on the molecular biology behind small bowel neoplasms and treatment options.
  
  
  METHODS
  The patient had a history of iron deficiency anemia and occult bleeding with extensive workup consisting of upper endoscopy, colonoscopy, capsule endoscopy, upper gastrointestinal series with small bowel follow through and push enteroscopy. Due to persistent abdominal pain and iron deficiency anemia the patient underwent push enteroscopy which revealed adenocarcinoma of the duodenum. The patient underwent en-bloc duodenectomy which revealed T3N1M0 adenocarcinoma of the 4th portion of the duodenum.
  
  
  CONCLUSIONS
  Primary duodenal carcinoma, although rare should be considered in the differential diagnosis of occult gastrointestinal bleeding when evaluation of the lower and upper GI tract is unremarkable. We discuss the current evaluation and management of this small bowel neoplasm.
authors.affiliation: Methodist University Physician Assistant Program, Fayetteville, North Carolina, USA.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Kalogerinis
authors.forename: John E
authors.initials: JE
authors.lastname: Poulos
authors.forename: Andrew
authors.initials: A
authors.lastname: Morfesis
authors.forename: Anthony
authors.initials: A
authors.lastname: Daniels
authors.forename: Stavroula
authors.initials: S
authors.lastname: Georgakila
authors.forename: Thomas
authors.initials: T
authors.lastname: Daignualt
authors.forename: Alexandros G
authors.initials: AG
authors.lastname: Georgakilas
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D003937:Diagnosis, Differential; D004379:Duodenal Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D004384:Duodenoscopy; D005260:Female; D006801:Humans; D007813:Laparotomy; D008022:Ligaments; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor