Carcinoid of the Minor Duodenal Papilla Associated With Pancreas Divisum: Case Report and Review of the Literature.

Waisberg, Jaques; Matos, Leandro Luongo de; Waisberg, Daniel Reis; Santos, Honória Virginea Brom dos; Fernezlian, Sandra Moraes; Capelozzi, Vera Luíza

doi:10.1590/s1807-59322006000400017

Cited by 25 publications

(15 citation statements)

References 18 publications

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“…Olgular, çoğunlukla asemptomatiktir. Ampuller nöroendokrin tümörlerin preoperatif tanısı oldukça zordur (2). Endoskopik ultrasonografi lezyonu tanımlamada, tümör invazyonunu ve bölgesel lenfadenopatileri saptamada değerli bir yöntemdir.…”

Section: Discussionunclassified

Pancreatic Divisum Associated with Ampullary Neuroendocrine Tumor and the Role of Magnetic Resonance Imaging

Kulalı¹,

Semiz-Oysu²,

Bükte³

2017

Haseki

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ÖzPankreatik divisum, pankreasın en sık konjenital anomalisidir. Pankreatik divisum ve malign tümör birlikteliği oldukça nadirdir. Duodenum ikinci kısım duvarında pankreatik ve biliyer kanalların birleştiği çok küçük bir alan olan ampuller bölgede, malign tümör görülme sıklığı oldukça azdır. Bu bölgede görülen tümörler, daha çok adenomlar ve karsinomlardır. Nöroendokrin tümörler, nöroendokrin sistemin enterokromofin hücrelerinden kaynaklanan tümörlerdir ve ampuller bölgede oldukça nadir görülürler. Ampuller bölge yerleşimli nöroendokrin tümörlerin preoperatif tanısı oldukça zordur. Literatürde, benzer olguların görüntüleme özelliklerine vurgu oldukça azdır. Bu bildiride, nadir bir olgu olan pankreatik divisuma eşlik eden ampuller nöroendokrin tümörün bilgisayarlı tomografi ve manyetik rezonans görüntüleme özellikleri sunuldu. Anahtar Sözcükler: Pankreatik divisum, nöroendokrin tümör, kanserPancreatic divisum is the most common anomaly of the pancreas. Pancreatic divisum associated with malignant tumor is rarely seen. The ampulla of Vater is formed by the union of the common bile duct and the pancreatic duct. The incidence of malignant tumor in the ampulla of Vater is very low. Adenomas and carcinomas are more common. Neuroendocrine tumors originate from enterochromaffin cells of the neuroendocrine system. Ampullary neuroendocrine tumors are very rare and preoperative diagnosis is very difficult. In the literature, the emphasis on imaging characteristics of similar cases is limited. Herein, we present a rare case of pancreatic divisum associated with ampullary neuroendocrine tumor and its characteristics of computed tomography and magnetic resonance imaging.

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Section: Discussionunclassified

Pancreatic Divisum Associated with Ampullary Neuroendocrine Tumor and the Role of Magnetic Resonance Imaging

Kulalı¹,

Semiz-Oysu²,

Bükte³

2017

Haseki

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“…It is rarer than even duodenal involvement defined as rare (2%) with this number (0.05%) [3, 4]. Its clinical presentation is composed of jaundice (53,1%), abdominal pain (24,6%), pancreatitis (6,0%), and weight loss (3,6%) [1–4]. Abdominal tomography and endoscopic imaging methods are also valuable besides clinical findings for making a diagnosis.…”

Section: Discussionmentioning

confidence: 99%

The Rare Malignancy of the Hepatobiliary System: Ampullary Carcinoid Tumor

Özsoy

Ozsoy²,

Canda³

et al. 2011

Case Reports in Medicine

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Introduction. Carcinoid tumors are low-grade tumors originating from endoderm and mostly involving the gastrointestinal system. However; they may be seen in any site within the gastrointestinal system. Case Presentation. A 69-year-old female patient. The results of blood tests were observed to be consistent with obstructive jaundice. A mass appearance was not encountered on tomographic examination. Papilla that was tumor-like macroscopically was seen in the second part of the duodenum in diagnostic endoscopy. Pylorus—preserving pancreaticoduodenectomy surgical procedure was applied. On pathological examination of the mass, a tumoral mass was detected in ampulla vateri localization, 1.5 × 1 × 0.8 cm in size, which, in immunohistochemical staining, was evaluated as a neuroendocrine tumor. Also, Metastasis was observed. Conclusion. The rarest type of carcinoid tumor is ampullary located carcinoid tumor, and tumor size is not a reliable indicator for tumor aggressivity in ampullary carcinoid tumors.

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“…Most reported cases have been submucosal benign tumors, such as carcinoid [12,15,19,22,23] and somatostatinoma [3,13,20]; only a single case of adenocarcinoma of the minor papilla has been previously reported [24]. Yamano et al [24] reported a 77-year-old male with an ulcerating tumor, in which the dorsal pancreatic duct epithelium was partially replaced by carcinoma cells from the minor papilla; however, details of the pathological findings were not described.…”

Section: Discussionmentioning

confidence: 99%

“…Most reported cases have been benign tumors, including carcinoid [12,15,19,22,23], somatostatinoma [3,13,20], adenoma [21], adenomyoma [4], and gangliocytic paraganglioma [11,14]; only one case of adenocarcinoma has been previously reported [24]. Tumors in the minor papilla may be underestimated because of the difficulty in determining the origin of tumors that involve the papilla because the papilla may be overgrown even by small tumors, and the histological appearance of periampullary tumors is similar [1].…”

Section: Introductionmentioning

confidence: 99%

Adenocarcinoma of the minor duodenal papilla with intraepithelial spread to the pancreatic duct

et al. 2007

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It is extremely rare to encounter tumors arising exclusively in the minor duodenal papilla. We report a 60-year-old male patient with a polypoid type of adenocarcinoma of the minor papilla. Preoperative examinations, including computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP), suggested pancreas divisum and showed a series of stones in the dorsal pancreatic duct. The patient underwent subtotal stomach-preserving pancreaticoduodenectomy (SSpPD). On histology, an adenocarcinoma was located in the minor papilla, which was limited to the mucosa, without invasion of the duodenum, sphincter muscles of the minor papilla, or the underlying pancreas. The carcinoma cells, together with dysplastic and hyperplastic epithelium of the pancreatic duct, extended peripherally within the pancreatic duct. No cystic dilatation of the pancreatic duct was observed. The ventral pancreatic duct was short and narrow; there was evidence of chronic pancreatitis in the dorsal pancreas, whereas the ventral pancreas was almost normal, suggesting the existence of pancreas divisum. Although it is well known that adenocarcinoma of the duodenal papilla is sometimes accompanied by intraepithelial spread in the pancreatic duct, an adenocarcinoma arising in the minor papilla in this case with pancreas divisum was more extended than our thoughts.

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Carcinoid of the Minor Duodenal Papilla Associated With Pancreas Divisum: Case Report and Review of the Literature.

Cited by 25 publications

References 18 publications

Pancreatic Divisum Associated with Ampullary Neuroendocrine Tumor and the Role of Magnetic Resonance Imaging

Pancreatic Divisum Associated with Ampullary Neuroendocrine Tumor and the Role of Magnetic Resonance Imaging

The Rare Malignancy of the Hepatobiliary System: Ampullary Carcinoid Tumor

Adenocarcinoma of the minor duodenal papilla with intraepithelial spread to the pancreatic duct

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