Duodenal villous adenomas

Two cases of villous adenoma of the duodenum are presented. These rare tumors are best diagnosed with upper gastrointestinal radiographs and endoscopic biopsy. Malignant degeneration is more common in the second portion of the duodenum which makes excision more difficult. If no malignancy is found, sleeve resection is preferred. Tumors in the second portion of the duodenum should be treated with wide mucosal excision if carcinoma in situ is found and with pancreaticoduodenectomy if invasive cancer is present.