Figure 1: (A and B) CT of the abdomen/pelvis demonstrates a large cystic mass within the duodenal wall. The mass is heterogeneously enhancing with areas suggestive of internal necrosis. A marked mass effect is seen upon the duodenal lumen. (C) Upper endoscopy demonstrates luminal narrowing of the second portion of the duodenum without mucosal involvement. (D) Endoscopic ultrasound demonstrates solid and cystic components in the duodenal wall lesion.