Non-vaterian duodenal adenomas: Report of 24 cases and review of the literature

J, Delpy; Bruneton, J.; Drouillard, J; Lecomte, P

doi:10.1007/bf01948106

Cited by 13 publications

(2 citation statements)

References 28 publications

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“…Adenomas account for about one-half of all benign duodenal neoplasms (1). Villous adenomas are a subtype of adenomatous polyps with high potential for malignant transformation.…”

Section: Discussionmentioning

confidence: 99%

Villous Duodenal Adenoma

Izgur

Dass²,

Solomides³

2010

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“…Adenomas account for about one-half of all benign duodenal neoplasms (1). Villous adenomas are a subtype of adenomatous polyps with high potential for malignant transformation.…”

Section: Discussionmentioning

confidence: 99%

Villous Duodenal Adenoma

Izgur

Dass²,

Solomides³

2010

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“…The age ranges of patients with duodenal villous lesions are broad, and there is no gender predominance [2,5]. Most lesions are found in the second portion of the duodenum with presenting symptoms usually related to biliary tract obstruction, occult bleeding, or obstruction of the duodenal lumen.…”

Section: Discussionmentioning

confidence: 99%

Quiz case of the month

et al. 1997

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An 84-year-old female presented with a 10-month history of epigastric pain. She had recently experienced nausea and bilious vomiting. There were no relevant details in her history. Physical examination revealed no abnormality and laboratory values were all within reference range.Plain abdominal film was unremarkable. Barium gastrointestinal study was performed, demonstrating an abnormal filling defect at the junction of the second and third parts of the duodenum, with distortion of the mucosal pattern (Fig. 1). Flecks of contrast material were seen interspersed throughout the sessile mucosal lesion. An abdominal/pelvic CT scan was performed by utilizing only oral contrast (Gastrographin), because the patient refused the administration of intravenous contrast media. It showed a 4-cm smoothly marginated intraluminal filling defect without associated wall thickening, without affecting the perilesional fat, and with discrete dilatation of the common bile duct (Fig. 2). Endoscopy supported the suspected diagnosis, which was confirmed by surgical exploration and the pathology report.

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Giant villous adenoma of the duodenum

Braga

Stella

Zerbi

et al. 1986

Journal of British Surgery

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Villous adenomas of the duodenum are rare and are often difficult to diagnose because of their non-specific symptoms. Of the 90 cases of villous adenoma of the duodenum reported in the literature, malignancy was discovered in almost half'. The present paper reports the largest villous adenoma of the duodenum yet described. Case reportA 73-year-old woman was admitted with a history of two episodes of fever with shivering. Other symptoms were pain in the right hypochondrium which often radiated to the back, anorexia and a weight loss of 9 kg (14 per cent of usual body weight). Laboratory data were: ESR, 22; haematocrit, 31.6 per cent; haemoglobin, 11 g/dl; serum amylase, 47 milliunits/ml (normal value (n.v.) i 36); alkaline phosphatase, 844 milliunits/ml (n.v. < 220); AST, 70 milliunits/ml (n.v. < 29); ALT, 55 milliunits/ml (n.v. < 36); GT, 598 milliunits/ml (n.v. < 36).Abdominal ultrasound showed a dilated common bile duct (14 mm) without evidence of stones, and suspicious periampullary mass. CT scan revealed dilated pancreatic and common bile ducts, but no mass in the head of the pancreas. Hypotonic duodenography showed a large multilobulated lesiom-partially occluding the second part of the duodenum. Endoscopy confirmed the presence of a wide multilobular lesion around the papilla of Vater. Biopsies of this mass were consistent with a diagnosis of duodenal villous adenoma (low grade dysplasia), Surgery was performed because of the dilated pancreatic and common bile ducts, and the large size and high probability of malignant change in the villous adenoma. At laparotomy the common bile duct appeared dilated, without obvious abnormality in the consistency of the head of the pancreas. Duodenotomy revealed a wide verrucous neoplasm of the second portion of the duodenum. Biopsies of this mass were consistent with duodenal villous adenoma (medium-grade dysplasia). Biopsy of a small, hard and reddish formation adjacent to the papilla revealed the presence of adenocarcinoma. Pancreaticoduodenectomy was performed. Pathological examination of the specimen revealed a 13 cm polypoid lesion of the second portion of the duodenum involving the papilla of Vater. Histological examination of the reddish lesion showed a muscus-secreting adenocarcinoma arising in the villous adenoma and invading the muscle layer. DiscussionAdenomas constitute about half of the benign neoplasms of the duodenum'. They include adenomatous polyps, Brunner's gland adenomas and villous adenomas. Whereas adenomas of Brunner's glands never degenerate', malignancy occurs in villous adenomas of the duodenum with variable frequency. Endoscopy should be performed in all cases of radiographically suspected duodenal tumours'. It permits specific pre-operative diagnosis of duodenal villous adenoma. but does not exclude cancer. The treatment of villous adenoma of the duodenum is still debated. Endoscopic resection may be justifiable for small villous adenomas arising in the first, third or fourth part of the duodenum but in all other cases laparotomy is indicated. ...

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Non-vaterian duodenal adenomas: Report of 24 cases and review of the literature

Cited by 13 publications

References 28 publications

Villous Duodenal Adenoma

Villous Duodenal Adenoma

Quiz case of the month

Giant villous adenoma of the duodenum

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