A 53-year-old man presented with a 6-month history of intermittent upper abdominal pain and vomiting. He reported no weight loss. Physical examination was normal. A barium contrast upper GI x-ray series disclosed a large polypoid mass in the duodenal bulb
(A). On endoscopy, the large polypoid lesion could be seen partially prolapsed through a dilated pylorus
(B). Endoscopic biopsy specimens of the lesion disclosed a tubulovillous adenoma. The patient underwent surgical resection of a 6 × 4 cm tubulovillous adenoma that arose in the duodenal bulb. No malignancy was found in the surgical specimen. The patient has been asymptomatic since resection of the lesion.
David M. Felig, MD, James Geuder, MD
Hackensack University Medical Center, Hackensack, New Jersey
Published in issue:Gastrointestinal Endoscopy, Volume 53, Issue 3, Page 341, March 2001