Benign nonampullary duodenal neoplasms.
Benign duodenal neoplasms (BDNs) are uncommon, and their optimal management remains undefined. We analyzed all cases of BDN treated at our institution during a 10-year period (January 1990 through January 2000). Data are expressed as median (range). Sixty-two patients were treated for BDNs. The results of histologic examination of their lesions were as follows: 36 adenomas, eight Brunner's gland tumors, 10 inflammatory polyps, two hamartomas, and six others. Forty-seven patients were treated nonoperatively, and 15 patients underwent surgery. Lesion characteristics leading to surgical intervention included large polyp diameter and submucosal penetration detected on endoscopic ultrasound imaging. There were no treatment-related deaths. Major morbidity occurred in 2% of patients who underwent endoscopic resection and in 33% of patients who underwent surgery (P = 0.002). Among patients treated for adenomas, seven (19.4%) had a recurrence at a median of 12 (4 to 48) months. Most BDNs can be managed with minimal morbidity using endoscopic techniques. Systematic follow-up of patients treated for adenomas is required.
Perez
Alexander
A
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., 02115, Boston, MA.
Saltzman
John R
JR
Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Carr-Locke
David L
DL
Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Brooks
David C
DC
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., 02115, Boston, MA.
Osteen
Robert T
RT
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., 02115, Boston, MA.
Zinner
Michael J
MJ
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., 02115, Boston, MA.
Ashley
Stanley W
SW
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., 02115, Boston, MA.
Whang
Edward E
EE
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., 02115, Boston, MA. ewhang1@partners.org.
D000236:Adenoma / Q000601:surgery; D011125:Adenomatous Polyposis Coli / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002011:Brunner Glands / Q000473:pathology; D004379:Duodenal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D019160:Endosonography; D005260:Female; D006801:Humans; D007417:Intestinal Polyps / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies