Miller GC, Kumarasinghe MP, Borowsky J, et al. - Fifty-seven cases of duodenal pyloric gland adenomas (PGA) were recognized and investigated from 56 patients to ascertain the clinicopathological characteristics of the PGA that arise in the duodenum. PGA tended to occur in the elderly with a slight female predominance. PGA arose more regularly in the proximal duodenum and usually present as mucosal nodules or plaques. In 22.8% of cases, there was correlated gastric heterotopia. PGA exhibiting characteristics of high-grade dysplasia were significantly greater in size vs PGA displaying only low-grade dysplasia and more inclined to explicate a tubulovillous rather than a pure tubular architecture. In this series, intramucosal or invasive carcinoma correlated with the duodenal PGA was noted in 10/56 individuals. Lymph node metastasis was exhibited by three of these carcinomas. After definitive treatment, local recurrence only transpired in three individuals. Thus, duodenal PGA tends to occur in the proximal duodenum of the elderly. The larger size and tubulovillous architecture correspond with high-grade dysplasia and correlated adenocarcinoma. Moreover, the low recurrence rate of these lesions would recommend endoscopic management is relevant, given the lesion could be fully resected.