Local Duodenal Metastasis from Colonic Carcinoma

The clinical and radiologic appearance of an isolated metastasis to the duodenum may mimic a primary pancreatic or duodenal cancer. As lymphatics from the right colon drain to periduodenal lymph nodes, lymphatic spread from right colon cancer can cause enlargement of the duodenal loop, with ulceration or distortion of the mucosa on the medial aspect of the duodenum. We present three patients with ulcerating metastases in the duodenum from colon cancer whose cases exemplify the problems of diagnosis and management.