title: Early duodenal adenocarcinoma resembling a submucosal tumor cured with endoscopic resection: a case report.
abstract: BACKGROUND
  Primary adenocarcinomas resembling submucosal tumors are rare in the gastrointestinal tract. Almost all the submucosal tumor-like adenocarcinomas previously reported invaded the submucosa or deeper. Therefore, submucosal tumor-like lesions are usually treated by surgical resection, and those that arise in the duodenum have been treated by pancreaticoduodenectomy.
  
  
  METHODS
  A 65-year-old Japanese man was diagnosed with a submucosal tumor-like adenocarcinoma in his duodenum. We considered it possible that the tumor invasion was limited to the mucosal or submucosal layers and could be removed by endoscopic resection. Tumor histopathology revealed a well-differentiated adenocarcinoma confined to the muscularis mucosae with no lymphovascular invasion. Complete resection of the carcinoma was achieved and there has been no recurrence three years after endoscopic resection.
  
  
  CONCLUSIONS
  We suggest that submucosal tumor-like adenocarcinomas arising in nonampullary duodenal sites should be diagnosed carefully with a view to possible endoscopic resection.
authors.affiliation: Department of Endoscopy, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan. akira.dobashi@nifty.com.
authors.forename: Akira
authors.initials: A
authors.lastname: Dobashi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Goda
authors.forename: Noboru
authors.initials: N
authors.lastname: Yoshimura
authors.forename: Kazuki
authors.initials: K
authors.lastname: Sumiyama
authors.forename: Hirobumi
authors.initials: H
authors.lastname: Toyoizumi
authors.forename: Shoichi
authors.initials: S
authors.lastname: Saito
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kato
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
authors.forename: Hisao
authors.initials: H
authors.lastname: Tajiri
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ikegami