title: Adenocarcinoma of the minor duodenal papilla: report of a case.
abstract: We report a rare case of adenocarcinoma of the minor papilla of the duodenum treated with transduodenal minor papillectomy. A 64-year-old woman was treated for an asymptomatic duodenal tumor detected on gastroduodenoscopy. Endoscopy showed a 15-mm sessile mass in the descending duodenum proximal to the major papilla. The major papilla was a villous 24-mm-diameter polypoid tumor. Histopathologic examination of the biopsy specimen showed tubular adenoma with moderate epithelial atypia. Transduodenal major and minor papillectomies were performed. The orifice of the duct of Santorini and the pancreatic duct were re-approximated to the duodenal wall to prevent acute pancreatitis caused by scarring and stenosis of the duct orifice. Histological findings were consistent with well-differentiated adenocarcinoma limited to the minor duodenal papilla, without infiltration of the duodenal wall submucosa, and confirmed complete resection. The patient had an uneventful postoperative course and has remained asymptomatic, without evidence of tumor recurrence or stenosis of the pancreatic duct orifice, for 4 years.
authors: Institute of Gastroenterology, Nippon Medical School Musashi Kosugi Hospital, Kawasaki, Kanagawa, Japan. kuma-3@momo.so.net.ne.jp
authors: Arichika
authors: A
authors: Hoshino
authors: Yoshiharu
authors: Y
authors: Nakamura
authors: Hideyuki
authors: H
authors: Suzuki
authors: Satoshi
authors: S
authors: Mizutani
authors: Hideaki
authors: H
authors: Ishii
authors: Masanori
authors: M
authors: Watanabe
authors: Hideki
authors: H
authors: Bou
authors: Masanori
authors: M
authors: Yoshino
authors: Osamu
authors: O
authors: Komine
authors: Eiji
authors: E
authors: Uchida
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002454:Cell Differentiation; D004379:Duodenal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D004384:Duodenoscopy; D004724:Endoscopy; D005260:Female; D006801:Humans; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011859:Radiography