Metastasis duodenum

Fig. 30.3a,b. Adenocarcinoma with spread into duodenum and liver metastasis, a There is a large, low-density mass in the uncinate process (arrow), but the duodenum is not well seen. There is a metallic biliary stent in place, b Coronal MPR demonstrates tumor invasion into the ascending part of the duo-... 

Malignant Tumours of the Stomach and Duodenum 102 Gastric Carcinoma 102 Gastric Lymphoma 103 Gastrointestinal Stromal Tumour 103 Metastasis to the Stomach 104 Primary Carcinoma of the Duodenum 104 Secondary Involvement of the Duodenum 105 Bezoars 107 References 108... 

Recurrent anastomotic ulcers when they occur are usually found on the jejunal side of the anastomosis (Fig. 5.8a). In patients who present with persistent or complex duodenal or anastomotic ulcer, especially if associated with diarrhoea, weight loss, and liver metastasis, Zollinger-Ellison syndrome should be suspected. The syndrome consists of recurrent intractable peptic ulcers caused by hypergastrinae-mia produced by gastrin-secreting tumours of the pancreas (75%) or duodenum (15%) (Hirschowitz 1997). Tumour localisation is critical to aid in the identification of patients with potentially respectable disease (Berg and Wolfe 1991). Twenty percent of patients have multiple endocrine neoplasia type I which includes parathyroid, pituitary, and adrenal tumours. 

Fig. 9.17. a Intraluminal villous adenoma. CECT shows a soft-tissue polypoid mass with a small pedicle, arising from the medial aspect of the descending duodenum, with no mural thickening or extraduodenal disease, b Malignant villous tumor of the duodenum. Note the extensive carpetlike lesion involving most of the inferior duodenal flexure as well as the liver metastasis (c)... 

Hematogenous spread from various primary tumours, mainly malignant melanoma, bronchogenic and breast carcinoma, may metastasize to the duodenum or diff use wall thickening (see Fig. 6.1.24). A metastasis may be seen on CT as an intraluminal soft tissue mass. Larger metastases often demonstrate intratumoral necrosis or cavitation, indistinguishable from lymphoma or leiomyosarcoma (JAYARAMAN et al. 2001) Zissin et al. 2002). 

---