[Acute XXXX as initial manifestation of a @entity674 ].

@entity1 @entity417 @entity548 @entity5 @entity1425 @entity1066 @entity615 @entity3 @entity674 @entity360
HISTORY: An 80-years-old @entity1 was admitted to our clinic because of @entity360 with tarry stool for 3 days after taking non steroidal antiinflammatory drugs (NSAID) for @entity615 . The history was otherwise unremarkable. INVESTIGATIONS: Laboratory results showed @entity417 . Initial endoscopy revealed @entity548 from an elevated @entity1066 in the pars inferior of the duodenum. The @entity548 was successfully treated by @entity1425 and fibrin injection. Biopsies showed inflammatory changes without presence of malignant cells. In the CT scan of the abdomen there was a mass near the ligament of Treitz of 6.3 cm in diameter adjacent to the duodenum. CLINICAL COURSE: The @entity5 was not suitable for ultrasound-guided biopsy. Therefore, laparotomy and surgical resection of the @entity5 were performed. Histology showed a @entity674 ( @entity674 ) with infiltration of the muscle layer of the duodenal wall with one small local metastasis. No lymph node @entity3 were present. The @entity5 was surgically completely removed and the regular follow-up examinations have fo far shown no evidence for @entity5 recurrence or @entity3 . CONCLUSIONS: In @entity360 from unusual sites, @entity674 has to be considered as an underlying disease even if endoscopic biopsies are negative for neoplastic changes.
