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Ladenocarcinome (ADK) du bulbe duodenal est une tumeur maligne rare du tube digestif qui a un faible taux dincidence et des symptomes non specifiques. Il est parfois difficile de poser un diagnostic precoce et le taux derreurs de diagnostic est eleve. La tomodensitometrie (TDM), limagerie par resonnance magnetique (IRM), lendoscopie digestive haute et dautres bilans morphologiquesdoivent etre combinees pour effectuer une evaluation complète. Le diagnostic de certitude de ce type de tumeur depend principalement de lexamen anatomo-pathologiquecomplete par un examen immunohistochimique. Le pronostic depend de lextension tumorale locoregionale et a distance, du nombre de ganglions envahis et de la marge de resection. Le traitement des formes localisees repose sur la resection chirurgicale. Pour les formes metastatiques non resecables, la chimiotherapie par les fluoropyrimidines avec loxaliplatine parait la meilleure option therapeutique. Ce cas clinique souligne la difficulte de poser un diagnostic dADK duodenal au stade precoce et linteret des biopsies duodenales devant toute lesions suspectes.
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