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Malignant diseases in the small bowel are quite rare, half of them are adenocarcinomas, and of these, nearly all are located in the duodenum or in the proximal jejunum. Here an adenocarcinoma situated in the duodenal bulb is seen.
The biopsies from this lesion in the distal part of the duodenal bulb showed a tubular adenoma, and in two biopsies a well differentiated adenocarcinoma was seen.The lumen is still open (seen in the lower part of the pictures, and this carcinoma does not yet cause any gastric retention.
This duodenal adenocarcinoma in the distal part of the bulbus (in the upper part of the picture to the left and in the middle of the picture to the right) caused bleeding anaemia as the only symtom.