Three cases of Solitary Peutz-Jeghers-type hamartomatous polyp in the duodenum

Suzuki, Seiyuu; Shoji, Hirokazu; Ikeda, Fusao; Yumoto, Eiichiro; Yamane, Hiromichi; Matsubara, Minoru

doi:10.3748/wjg.14.944

Cited by 38 publications

(23 citation statements)

References 10 publications

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“…These lesions have been described as having a lobular or nodular surface, whitish colour and whitish spots on the surface. Endoscopic removal is indicated as there is a small risk of malignant transformation [Suzuki et al 2008].…”

Section: Submucosal Lesionsmentioning

confidence: 99%

Endoscopic management of nonampullary duodenal polyps

Basford

Bhandari

2011

Therap Adv Gastroenterol

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Duodenal polyps are a rare finding in patients presenting for gastroscopy, being found in 0.3-4.6% of cases. The majority of patients are asymptomatic. The most common lesions necessitating removal are duodenal adenomas which should be differentiated from other mucosal lesions such as ectopic gastric mucosa, and submucosal lesions such as carcinoids and gastrointestinal stromal tumours (GISTs). Adenomas can occur sporadically or as part of a polyposis syndrome. Both groups carry malignant potential but this is higher in patients with a polyposis syndrome. The majority of sporadic duodenal adenomas are flat or sessile and occur in the second part of the duodenum. Historically duodenal adenomas have been managed by radical surgery, which carried significant mortality and morbidity, or more conservative local surgical excision which resulted in high local recurrence rates. There is growing evidence for the use of endoscopic mucosal resection (EMR) techniques for treatment of sporadic nonampullary duodenal adenomas, with good outcomes and low complication rates. Endoscopic submucosal dissection (ESD) carries greater risk of complications and should be reserved for experts in this technique. Patients with sporadic duodenal adenomas carry an increased risk of colonic neoplasia and should be offered colonoscopy. The impact of endoscopic resection on the course of polyposis syndromes such as familial adenomatous polyposis (FAP) needs further study.

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Section: Submucosal Lesionsmentioning

confidence: 99%

Endoscopic management of nonampullary duodenal polyps

Basford

Bhandari

2011

Therap Adv Gastroenterol

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“…A literature review showed only 13 similar reports in 23 patients of solitary duodenal hamartomas (Table 1). [2][3][4][11][12][13][14][15][16][17][18][19][20] Malignant transformation has only been reported twice. 4,20 The fi rst case was an 84-year-old woman who presented with gastrointestinal bleeding.…”

Section: Discussionmentioning

confidence: 99%

Solitary duodenal hamartomatous polyp with malignant transformation: Report of a case

et al. 2009

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A solitary duodenal hamartomatous polyp is rare and it is considered to be either a variant of Peutz-Jeghers syndrome (PJS) or a separate entity. Patients do not have cutaneous manifestations and have only one hamartomatous polyp. The presentation is nonspecific and it resembles common conditions, such as a peptic ulcer disease. Most are incidentally diagnosed during endoscopy for other indications. Malignant transformation has been reported. This report describes the case of a 46-year-old man who presented with chronic intermittent abdominal pain. The initial endoscopy showed an abnormal twisting of the duodenum with a dilated duodenum. He was later diagnosed to have a solitary duodenal hamartomatous polyp with malignant transformation, which was treated by surgery. A review of the literature on the pertinent cases of this type of lesion is also presented.

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“…A search of case reports on the MEDLINE database up to 2014 using the terms "solitary", "duodenum", and "hamartomatous polyp", but without PJS, identified 19 patients in 13 studies published in English with solitary-PJ type polyps in the duodenum, including the patient described here [2,[5][6][7][8][9][10][11][12][13][14][15] (Table 1). Age at onset ranged from 23-89 years (mean ± SD: 60.3 ± 20.1 years).…”

Section: Discussionmentioning

confidence: 99%

Endoscopic snare papillectomy for a solitary Peutz-Jeghers-type polyp in the duodenum with ingrowth into the common bile duct: Case report

Suzuki

Higuchi

Shimizu

et al. 2015

WJG

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Solitary duodenal Peutz-Jeghers (PJ)-type hamartomatous polyps are rare and considered a different disease entity than classic PJ syndrome. We describe the case of an 89-year-old man admitted to our emergency department with symptoms of acute cholangitis, liver dysfunction, and slight jaundice. Magnetic resonance imaging showed multiple signal voids, reflecting choledocholithiasis, and an ovalshaped tumor in the common bile duct (CBD). Following endoscopic retrograde cholangiopancreatography, the patient was diagnosed with a lower CBD tumor 20 mm in diameter. Endoscopic sphincterotomy was performed for choledocholithotomy, resulting in the expulsion of a large tumor with a stalk connected to the papilla of Vater. The tumor was successfully excised en bloc by endoscopic snare papillectomy. Histopathologic examination showed that the tumor was a PJ-type hamartomatous polyp. No mucocutaneous pigmentation of the skin was evident and the patient's family history was negative. Solitary duodenal PJ-type hamartomatous polyps are usually diagnosed incidentally during endoscopy for other indications because most of these tumors are asymptomatic or have nonspecific presentations. To our knowledge, this is the first reported solitary PJ-type polyp with intra-CBD growth treated by endoscopic snare papillectomy.

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Three cases of Solitary Peutz-Jeghers-type hamartomatous polyp in the duodenum

Cited by 38 publications

References 10 publications

Endoscopic management of nonampullary duodenal polyps

Endoscopic management of nonampullary duodenal polyps

Solitary duodenal hamartomatous polyp with malignant transformation: Report of a case

Endoscopic snare papillectomy for a solitary Peutz-Jeghers-type polyp in the duodenum with ingrowth into the common bile duct: Case report

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