title: Treatment of ampullary neuroendocrine tumor by endoscopic snare papillectomy.
abstract: METHODS
  Female, 45 FINAL DIAGNOSIS: Neuroendocrine tumor Symptoms: Abdominal pain Medication: - Clinical Procedure: - Specialty: Gastroenterology and Hepatology.
  
  
  OBJECTIVE
  Unusual setting of medical care.
  
  
  BACKGROUND
  Neuroendocrine tumor of the ampulla of Vater is extremely rare and is generally a low-grade endocrine cell tumor. The merits of radical vs. local resection remain uncertain.
  
  
  METHODS
  A 45-year-old female patient presented with abdominal pain lasting for 2 months. Papilla that was tumor-like macroscopically was seen in the second part of the duodenum in endoscopic retrograde cholangiopancreatography. Biopsy was histologically confirmed as a low-grade neuroendocrine tumor. No lymphadenopathy or visceral metastasis was found on an abdominal CT scan, In-111 octreotide scan, and EUS. The ampulla was removed by endoscopic snare papillectomy. All margins of resection were negative for tumor.
  
  
  CONCLUSIONS
  Endoscopic snare papillectomy may be the first step in the management of neuroendocrine tumors of the ampulla of Vater in high-risk surgical candidates and selected patients such as those with a well differentiated, low-grade, small tumor without regional/ distant metastasis. However, it can also be used in younger patients who wish to avoid surgical resection.
authors.affiliation: Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul,Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Odabasi
authors.forename: Kamil Mehmet
authors.initials: KM
authors.lastname: Yildiz
authors.forename: Eris
authors.initials: E
authors.lastname: Cengiz
authors.forename: Abuoglu Haci
authors.initials: AH
authors.lastname: Hasan
authors.forename: Emre
authors.initials: E
authors.lastname: Gunay
authors.forename: Erkan
authors.initials: E
authors.lastname: Ozkan
authors.forename: Ali
authors.initials: A
authors.lastname: Aktekin
authors.forename: Bulent
authors.initials: B
authors.lastname: Kaya
authors.forename: Tolga Munip Ali
authors.initials: TM
authors.lastname: Muftuoglu
keywords: ampulla of Vater; endoscopic papillectomy; endoscopic retrograde cholangiopancreaticography; neuroendocrine tumor