Duodenal tumors may pose diagnostic difficulties in asymptomatic young patients because the duodenum may be overlooked during routine upper gastrointestinal endoscopy and because duodenal tumors are rare and present non-specific signs and symptoms. Although adenomas are the most common duodenal tumors, adenocarcinoma arising from sporadic tubulovillous adenoma without familial adenomatous polyposis is an uncommon condition in young patients. In patients with sporadic duodenal adenomas, the prevalence of colorectal adenomas is higher than prevalence for the general population. Herein, we report the case of a 27-year male with adenocarcinoma arising from a sporadic tubulovillous adenoma of the duodenum. The tumor was completely resected by endoscopic resection. Synchronous colon adenoma was also detected and treated by endoscopic mucosal resection. (Korean J Gastrointest Endosc 2010;41:108-112)