title: [Papillary tumors - therapeutic concepts].
abstract: Papillary tumors originate from the various structures of the ampulla of Vater; therefore, these rare tumors represent a heterogeneous group of tumor entities. Intestinal differentiated adenomas are the most common benign lesions, whereas intestinal differentiated papillary carcinomas are the most common malignant tumors. Carcinomas with pancreaticobiliary differentiation have a poorer prognosis. Mesenchymal and neuroendocrine tumors are among the least frequent papillary tumors. Diagnosis is performed by side-view upper endoscopy and biopsy. In cases of suspected malignancy a complete staging with computed tomography (CT) and endoscopic ultrasound scanning is indicated to determine local tumor spread.Adenomas are removed by endoscopic snare papillectomy whereas the therapy of choice for papillary carcinomas is pancreatic head resection with systematic lymphadenectomy. Patients with papillary carcinomas are most likely to benefit from adjuvant therapy, which should be determined in an interdisciplinary consensus conference considering the histological differentiation of the tumor.
authors.affiliation: Universitätsklinik für Allgemein-, Viszeral- und Gefäßchirurgie, Leipziger Str. 44, 39120, Magdeburg, Deutschland, felix.popp@med.ovgu.de.
authors.forename: F C
authors.initials: FC
authors.lastname: Popp
authors.forename: J
authors.initials: J
authors.lastname: Weigt
authors.forename: T
authors.initials: T
authors.lastname: Kalinski
authors.forename: C
authors.initials: C
authors.lastname: Betzler
authors.forename: J
authors.initials: J
authors.lastname: Arend
authors.forename: B
authors.initials: B
authors.lastname: Garlipp
authors.forename: C
authors.initials: C
authors.lastname: Benckert
authors.forename: C J
authors.initials: CJ
authors.lastname: Bruns
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D014670:Ampulla of Vater / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003299:Cooperative Behavior; D006801:Humans; D033183:Interdisciplinary Communication; D009367:Neoplasm Staging; D010179:Pancreas / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D015996:Survival Rate; D014057:Tomography, X-Ray Computed