The pocket of doom - carcinoma of the duodenal diverticulum

Duodenal diverticula are relatively common and usually asymptomatic. However, malignant transformation within these structures is exceedingly rare. The clinical presentation is often non-specific. This uncommon manifestation poses significant challenges in both diagnosis and treatment. Two cases involving patients diagnosed with duodenal diverticular carcinomas have been presented. The first case exhibited imaging characteristics consistent with an enhancing mass within a duodenal diverticular pocket, with hepatic metastasis. This case was accurately diagnosed through contrast-enhanced computed tomography (CECT). The second case involved a patient with a history of recurrent pancreatitis, who was misdiagnosed with mass-like pancreatitis based on findings from both CECT and magnetic resonance imaging (MRI). Unfortunately, both patients succumbed to their illness within two months following confirmation of the pathology. Duodenal diverticular carcinoma presents a significant diagnostic challenge due to the limited availability of medical literature. Nevertheless, early diagnosis is crucial for improving therapeutic outcomes.