Villous Adenomas of the Duodenum and an Unusual Variant

Abstract

We report two cases of villous adenoma of the duodenum, one arising from the main papilla and the other from the accessory papilla. Both were managed by local resection. In one case endoscopic biopsies and intraoperative frozen sections were negative for carcinoma but histology of the locally resected specimen revealed a focus of invasive adenocarcinoma. Villous adenomas of the duodenum have a high risk of malignant change and foci of carcinoma can be missed on endoscopic biopsy. The literature is reviewed and the clinical, diagnostic, pathological and therapeutic aspects of villous adenomas of the duodenum are discussed.

Villous Adenocarcinoma of the Duodenum Invading the Ampulla of Vater: Case Report and Review of Literature

“…Chappuis states that endoscopic excision has to be performed in all cases except those with invasive carcinoma. Evans 22 believes that endoscopic exision should be confined to a polypoid lesion. Some authors think that local excision should be reserved for villous adenoma with carcinoma in situ5'12, others believe this should be reserved for tumours of the I, II and IV duodenal portion4'22.…”

Jejunuminterponat als Ersatz der Pars descendens duodeni bei ausgedehntem tubulovillösen Adenom

“…Dabei sind etwa 50 % aller duodenalen Neoplasmen bösartig. Die Diagnostik beinhaltet die Oesophagogastroduodenoskopie mit Biopsieentnahme, die Endosonographie, eine CT sowie gegebenenfalls eine ERCP bei der häufig papillennahen Lage der Tumoren [9]. Der gröûte Teil der Tumoren ist in der Pars II mit 64 % (Pars I = 22 % und Pars III = 14 %) lokalisiert [15].…”