Endoscopic Mucosal Resection of Adenocarcinoma at the Minor Duodenal Papilla: A Case Report and Suggestions for the Optimal Treatment Strategy

Abstract

We herein report an extremely rare case of adenocarcinoma of the minor duodenal papilla (MiDP) which was successfully treated by endoscopic mucosal resection (EMR). An asymptomatic 84-year-old man underwent upper gastrointestinal endoscopy, which revealed a slightly elevated lesion at the MiDP. The biopsy findings were suggestive of adenocarcinoma. Computed tomography, magnetic resonance images and endoscopic ultrasonography did not reveal pancreatic tumor infiltration nor any apparent distant metastases. Therefore, we treated the lesion using EMR with complete resection. No recurrence or metastasis has been detected at 13 months after EMR. Total resection of the MiDP can thus serve as a relatively safe and simple treatment.

Endoscopic papillectomy for tumors of the minor duodenal papilla: A case series of six patients and literature review

“…Table 2 summarizes the published reports of tumors of the minor duodenal papilla that were treated by EP. [8][9][10][11][12][13][14][15][16] Including our six cases in Table 1, a total of 15 cases have been reported (adenocarcinoma, 3; carcinoma in adenoma, 2; adenoma, 3; NET, 4; others, 3). A plastic stent was not placed in the dorsal pancreatic duct in any of these cases, with the exception of one case with pancreatic divisum.…”

“…Therefore, most of those tumors are detected at an advanced stage, and there are very few reports of outcomes of endoscopic treatment for tumors of the minor duodenal papilla that are detected early. Table 2 summarizes the published reports of tumors of the minor duodenal papilla that were treated by EP 8–16 . Including our six cases in Table 1, a total of 15 cases have been reported (adenocarcinoma, 3; carcinoma in adenoma, 2; adenoma, 3; NET, 4; others, 3).…”