Villous adenoma of the duodenum. A clinicopathologic study of five cases.

Villous adenoma of the duodenum (VAD) is a rare tumor occurring predominantly in middle-aged adults and most commonly found in the second portion of the duodenum. The authors describe five cases of VAD and discuss histologic criteria for diagnosis of malignant transformation. Diagnostically, more than 90 per cent of all lesions are identified by upper gastrointestinal series and endoscopy. Treatment of choice for benign lesions is local excision, while malignant lesions should be treated with more extensive resection. In situ carcinoma in the elderly should be managed on an individual basis.