PMC7569183_01
CT-enterography image of the lesion.
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The report described "in the transition between D3 and D4, an exophytic lobulated mass, apparently originating from the duodenal wall, heterogeneous, with hypodense central regions (of necrosis) and peripheral contrast-enhancement areas, measuring 64 x 53 x 73 mm, molding its shape to conform to the adjacent structures, without clear invasion (...)" (Fig. 1).
GIST in the fourth duodenal portion.
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We found a bulky neoplasm compatible with GIST, with approximately 10 cm in diameter and prominent neovascularization, involving D4 with extension to the Treitz's angle (Fig. 2).
End-to-end duodenojejunal anastomosis.
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A segmental duodenectomy (D3-D4) with a two-layer interrupted end-to-end anastomosis (Fig. 3) was then performed.
Final operative specimen.
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The operative specimen is presented in Fig. 4.