title: Synchronous adenocarcinoma of the major and minor duodenal papilla.
abstract: A 50-year-old woman presented with pancreatitis, fluctuant jaundice, weight loss, and abdominal pain. Contrast-enhanced computed tomography and abdominal ultrasound showed slight dilatation of the biliary tree and gallbladder without calculi. Endoscopy demonstrated a tumor protruding from the papilla of Vater. First endoscopically biopsy diagnosed no tumor, and a second biopsy diagnosed as papillary adenocarcinoma. The patient underwent duodenopancreatectomy. The specimen was fixed in formalin (10%). The tissue was processed routinely, and paraffin sections were stained with hematoxylin-eosin and periodic acid Schiff. Gross examination showed two tumors seen as prolapsed nodules growing isolated from the minor and major duodenal papillae measuring 1.5 and 1.0 cm, respectively, both covered by duodenal mucosa and the histologic study of both lesions demonstrated a moderately differentiated tubular adenocarcinoma, which invaded duodenal wall. After surgery, she is alive 24 months without evidence of recurrence.
authors: Department of Gastroenterology, University of Sao Paulo, Sao Paulo, Brazil. asmatheus@hotmail.com
authors: Andre Siqueira
authors: AS
authors: Matheus
authors: Jose
authors: J
authors: Jukemura
authors: Andre L
authors: AL
authors: Montagnini
authors: Tiago
authors: T
authors: Kunitake
authors: Rosely A
authors: RA
authors: Patzina
authors: Jose Eduardo Monteiro
authors: JE
authors: da Cunha
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D014670:Ampulla of Vater; D001706:Biopsy; D003138:Common Bile Duct Neoplasms / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D010183:Pancreatic Ducts; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000379:methods