We examined 15 cases of primary duodenal cancer except ampullary cancer. Four cases of cancer in the bulb included 3 early cancers, and 11 cases of cancer in the 2nd portion included 2 early cancers. Histopathological examination showed 3 poorly, 1 moderately, and 11 well differentiated adenocarcinomas. Three cases of early elevated cancer in the bulb were performed endoscopic mucosal resection (EMR) , but 1 case was added surgical operation because of invasion into the submucosal layer. All patients of early cancer, except one patient died of another disease, are still alive. But 7 patients of advanced cancer died within two years after surgical operation. The early cancer of poorly differentiated adenocarcinoma formed IIa type with normal mucosa on the outside area.
