Case Presentation

A 68-year-old woman with a history of arterial hypertension and Gilbert´s syndrome was referred to a Gastroenterology consultation due to adenomyomatosis of the gallbladder.

Additionally, laboratory results reveal changes on liver tests and an abdominal computed tomography (CT) was initially performed. An incidentaloma on the second part of the duodenum was described (arrow). Then, the upper digestive endoscopy did not reveal any significant alteration and an abdominal magnetic resonance imaging (MRI) was performed for further investigation of this lesion. (Figs. 1, 2, 3) What is your diagnosis?

Figure 1: A- Axial soft tissue window, 2.5 mm slice thickness, non-enhanced CT; B- contrast-enhanced CT in arterial phase; C- portal venous phase. 

Figure 2: A- Axial contrast-enhanced T1-weighted fat suppressed MRI in arterial; B- portal; C- equilibrium phases. 

Figure 3: A- Axial T2 haste image; B- Diffusion weighted sequence on b700 image (DWI); C- Apparent diffusion coefficient map (ADC).