2 , 4 , 5 , 6 While duodenoscopy could be enough in detecting these tumors, some problems may arise when the tumor is relatively small in diameter with very non-significant outward expansion or the lack of an ulcerated umbilication. 2 , 4 , 6 In such conditions endoscopic ultrasound is highly helpful in determining whether the lesion is submucosal or arises from an intramural or extramural structure; it can also be performed to clarify the layer of origin of the intramural lesion. 10 CT and MRI are the best imaging methods for estimating the primary lesion and finding the presence of metastasis.
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