Approach to the endoscopic resection of duodenal lesions

Table 1 Types and characteristics of various duodenal lesions that can be encountered on upper endoscopy

Type of duodenal lesion	Duodenal wall layer	Malignant potential	Requires resection	Amenable to endoscopic resection
Lipoma	Subepithelial	No	No	Possible
Gastrointestinal stromal tumors	Subepithelial	Yes	Yes	Possible
				(for small lesions); often requires surgery
Carcinoids	Subepithelial	Yes	Yes	Possible
				(for rare, isolated lesions); often requires surgery
Brunner’s gland “adenomas” or hamartomas	Mucosal	No	If patients are symptomatic	Yes
Solitary Peutz-Jeghers polyps	Mucosal	Yes	Yes	Yes
Adenoma	Mucosal	Yes	Yes	Yes