A wide variety of tumors arise at the major duodenal papilla. The special significance
of these lesions is that they represent a less serious prognosis for patients compared
with that for other peripapillary neoplasms.
1
However, cure depends on correct diagnosis at an early stage. Endoscopy is the most
valuable of the available imaging methods because it provides not only direct visualization
of the lesion but often a tissue diagnosis as well. Moreover, because the major duodenal
papilla is encountered during routine upper endoscopy, albeit only partially seen
in most cases, it is important to recognize and understand the characteristic endoscopic
findings of papillary tumors. In addition, endoscopy now plays an important role in
the treatment of these tumors.To read this article in full you will need to make a payment
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References
- Peripapillary and pancreatic cancer.in: Surgery of the liver and biliary tract. Churchill Livingston, Edinburgh1988: 855-861
- Villous adenoma of the major duodenal papilla. An unusual cause of biliary colic and obstructive jaundice.Gastroenterology. 1978; 75: 107-109
- Neoplasia of the major duodenal papilla Ki-ras and p53 mutations.Am J Pathol. 1993; 142: 1163-1172
- Laser treatment of tumors of the papilla of Vater.Endoscopy. 1988; 20: 227-231
- Adenomatous residue in cancerous papilla of Vater.Gut. 1981; 22: 1031-1034
- Morphogenesis and possible precursor lesions of invasive carcinoma of the papilla of Vater: epithelial dysplasia and adenoma.Hum Pathol. 1985; 16: 305-310
- Villous tumors of the duodenum: biologic characters and clinical implications.Scand J Gastroenterol. 2000; 35: 337-344
- Benign villous adenomas of the major duodenal papilla.Cancer. 1986; 58: 1563-1568
- Recurrent acute pancreatitis caused by papillary villous adenoma.J Clin Gastroenterol. 1990; 12: 200-202
- Villous adenoma involving the major duodenal papilla: treatment by submucosal resection and double sphincteroplasty.Am Surg. 1982; 48: 188-190
- Clinical significance of magnetic resonance cholangiopancreatography (MRCP) compared to endoscopic retrograde cholangiopancreatography (ERCP).Endoscopy. 1997; 29: 182-187
- Extrahepatic biliary diseases: 3D MR cholangiopancreatography compared with endoscopic retrograde cholangiopancreatography.Radiology. 1997; 202: 663-669
- Magnetic resonance imaging in gastroenterology: time to say good-bye to all that endoscopy?.Endoscopy. 2000; 32: 406-410
- Clinical and endoscopic aspects of tumors of the major duodenal papilla.Endoscopy. 1988; 20: 211-217
- Diagnosis of duodenal and papillary epithelial neoplasms by endoscopic biopsy: a clinicopathologic and immunohistochemical study.Hum Pathol. 1985; 16: 901-910
- Villous adenoma of the major duodenal papilla.Gastrointest Endosc. 1979; 25: 155-156
- Carcinoma of the major duodenal papilla A clinicopathologic study and pathologic staging of 109 cases of carcinoma and 5 cases of adenoma.Cancer. 1987; 59: 506-515
- Carcinoma of the major duodenal papilla: the endoscopic approach.Endoscopy. 1988; 20: 223-226
- Villous tumors of the duodenum: a retrospective study of 47 cases by the French Associations for Surgical Research.J Am Coll Surg. 1995; 180: 541-544
- Duodenal villous tumors.Arch Surg. 1990; 125: 961-965
- Duodenoscopy and biopsy.in: The papilla of Vater and its diseases. Uerhard Wirtzsrock, Baden Baden, Germany1979: 66
- Tumors and pseudotumors of the region of the major duodenal papilla: an endoscopic, clinical and pathological study.Gut. 1986; 27: 1186-1192
- Endoscopic biopsies of the papilla of Vater at the time of endoscopic sphincterotomy: difficulties in interpretation.Gastrointest Endosc. 1984; 30: 163-166
- Endoscopic treatment of papillary adenomas in familial adenomatous polyposis.J Clin Gastroenterol. 1996; 22: 237-241
- Adenocarcinoma of the major duodenal papilla. Diagnosis and treatment.Ann Surg. 1982; 195: 152-157
- Villous tumors of the duodenum.Ann Surg. 1986; 203: 301-306
- Adenoma and carcinoma of the duodenum and papilla of Vater: a clinicopathologic study.Am J Gastroenterol. 1992; 87: 37-42
- Clinical features in familial polyposis coli. Results of the Danish Polyposis Register.Dis Colon Rectum. 1986; 29: 102-107
- High prevalence of adenomatous polyps of the duodenal papilla in familial adenomatous polyposis.Dig Dis Sci. 1989; 34: 167-170
- Can APC mutation analysis contribute to therapeutic decisions in familial adenomatous polyposis? Experience from 680 FAP families.Gut. 2001; 48: 515-521
- Familial adenomatous polyposis: should patients undergo surveillance of the upper gastrointestinal tract?.Endoscopy. 1995; 27: 6-11
- Gastroduodenal polyps in patients with familial adenomatous polyposis.Dis Colon Rectum. 1992; 35: 1170-1173
- Endoscopic features of adenoma of the duodenal papilla in familial polyposis of the colon.Gastrointest Endosc. 1981; 27: 6-8
- Upper gastrointestinal polyps in Gardner's syndrome.Gastroenterology. 1984; 86: 295-301
- The natural history of untreated duodenal and papillary adenomas in patients with familial adenomatous polyposis followed in an endoscopic surveillance program.Gastrointest Endosc. 1999; 49: 358-364
- The risk of upper gastrointestinal cancer in familial adenomatous polyposis.Gastroenterology. 1992; 102: 1980-1982
- Mortality in patients with familial adenomatous polyposis.Dis Colon Rectum. 1990; 33: 639-642
- Upper gastrointestinal cancer in patients with familial adenomatous polyposis.Lancet. 1989; 2: 783-785
- Upper gastrointestinal cancer in familial adenomatous polyposis.Lancet. 1988; 1: 1149-1151
- Prognosis of symptomatic duodenal adenomas in familial adenomatous polyposis.Arch Surg. 1991; 126: 825-828
- The impact of familial adenomatous poltposis on the tumorigenesis and mortality at the several organs: its rational treatment.Ann Surg. 1993; 217: 101-108
- Changing causes of mortality in patients with familial adenomatous polyposis.Dis Colon Rectum. 1996; 39: 384-387
- Endoscopic snare papillectomy in patients with familial adenomatous polyposis and papillary adenoma.Endoscopy. 1997; 29: 685-688
- Endoscopic surveillance and ablative therapy for peripapillary adenomas.Am J Gastroenterol. 2001; 96: 101-116
- Management of peripapillary adenoma.Dig Dis. 1998; 16: 266-273
- Results of surgical treatment of peripapillary tumors: a thirty-five-year experience.Surgery. 1986; 100: 716-723
- Endoscopic sphincterotomy and endoscopic fulguration in the management of adenoma of the papilla of Vater.Surg Gynecol Obstet. 1989; 169: 445-448
- Endoscopic therapy of benign tumors of the papilla of Vater: a clinicopathologic study.Am J Gastroenterol. 1992; 87: 37-42
- Villous tumors of the major duodenal papilla: local resection versus pancreatoduodenectomy.South Med J. 1989; 82: 917-920
- Local resection or pancreaticoduodenectomy for villous adenoma of the major duodenal papilla diagnosed before operation.Br J Surg. 1997; 84: 948-951
- Transduodenal excision of tumors of the major duodenal papilla.Eur J Surg. 1996; 162: 961-967
- Local resection for papillary tumors. Is there a place for it?.Arch Surg. 1993; 128: 515-520
- Management of duodenal adenomas in 98 patients with familial adenomatous polyposis.Endoscopy. 1999; 31: 412-416
- Endoscopic snare excision of benign adenomas of the papilla of Vater.Gastrointest Endosc. 1993; 39: 127-131
- Clinicopathologic features and endoscopic resection of duodenal adenocarcinomas and adenomas with the submucosal saline injection technique.Gastrointest Endosc. 1997; 46: 507-513
- Contribution of endoscopy to diagnosis and treatment of tumors of the major duodenal papilla.Cancer. 1989; 64: 161-167
- Use of ERCP and papillectomy in management of papillary tumors: seven-year review of 75 cases at Indiana University Medical Center.Gastrointest Endosc. 2001; 53 ([abstract]): AB88
- Endoscopic snare resection for tumors of the major duodenal papilla.Yonsei Med J. 2000; 41: 213-218
- Indications for local excision of papillary lesions associated with familial adenomatous polyposis.J Am Coll Surg. 1994; 179: 462-464
- The use of endoscopic ultrasonography in the diagnosis and staging of carcinoma of the papilla of Vater.Endoscopy. 1988; 20: 218-222
- Ampullopancreatic carcinoma: preoperative TNM classification with endosonography.Radiology. 1990; 175: 455-461
- Endosonography in staging early carcinoma of the ampulla of Vater.Gastroenterology. 1992; 102: 1392-1395
- Staging of papillary and pancreatic carcinoma: comparison between endosonography and surgery.Gastrointest Endosc. 1996; 44: 706-713
- Results of surgical treatment of peripapillary tumors: a thirty-five-year experience.Surgery. 1986; 100: 716-723
- Endoscopic resection of duodenal ampulla with a transparent plastic cap.Surgery. 1998; 123: 109-110
- Carcinoma of the major duodenal papilla.Br J Surg. 1986; 73: 72-73
- Adenocarcinoma of the major duodenal papilla. A 28-year experience.Ann Surg. 1997; 225: 590-600
- Peripapillary tumors: which ones should be resected?.Am J Surg. 1985; 149: 46-52
- “Fiberduodenoscopy”—early diagnosis of cancer of the papilla of Vater.Surgery. 1970; 67: 561-565
- Carcinoma of the major duodenal papilla.Ann Surg. 1987; 206: 572-577
- Endoscopic sphincterotomy in carcinoma of the major duodenal papilla.Gastrointest Endosc. 1982; 28: 203-204
- Ballooning of the papilla during contrast injection: the semaphore of a choledochocele.Gastrointest Endosc. 1998; 48: 258-262
- Precut (needle knife) papillotomy for impacted common bile duct stone at the ampulla.Am J Gastroenterol. 1990; 85: 991-993
- Primary early carcinoma of duodenum: report of a case and clinico-pathological review of Japanese literature.Gastroenterol Endosc. 1986; 28: 1610-1618
- Endoscopic palliation for cancer of the papilla of Vater. Comparison to a surgically treated cohort.Gastrointest Endosc. 2001; 53: AB95
- Carcinoid of the major duodenal papilla Clinical characteristics and morphologic features.Cancer. 1994; 73: 1580-1588
- Neuroendocrine papillary tumors: spectrum of disease including the first report of a neuroendocrine carcinoma of non-small cell type.Surgery. 1994; 115: 762-766
- Neuroendocrine tumors of the gastrointestinal tract.Pathol Res Pract. 1988; 183: 143-154
- Somatostatinoma of the major duodenal papilla.Gastrointest Endosc. 1996; 44: 612-614
- Adenocarcinoid tumor of the major duodenal papilla.Am Surg. 1998; 64: 355-359
- Carcinoid tumors of the major duodenal papilla: a comparison with duodenal carcinoid tumors.Cancer. 1999; 85: 1241-1249
- Carcinoid tumour of major duodenal papilla associated with viscero-cutaneous neurofibromatosis.Postgrad Med J. 1983; 59: 734-735
- Peripapillary neoplasms in von Recklinghausen's disease.Surgery. 1989; 106: 815-819
- Carcinoid of the major duodenal papilla presenting as acute pancreatitis.Am J Gastroenterol. 1996; 91: 2426-2427
- Endosonography-guided endoscopic resection of duodenal carcinoid tumor.Endoscopy. 1997; 29: 214-217
- Carcinoid of the major duodenal papilla. Local resection or pancreaticoduodenectomy.Cancer. 1993; 71: 686-690
- Endoscopic resection of two duodenal carcinoid tumors.Endoscopy. 2000; 32: S42
- Carcinoid tumors of the duodenum. A clinicopathologic study of 99 cases.Arch Pathol Lab Med. 1990; 114: 700-704
- Carcinoid tumors of the gastrointestinal tract: evaluation with endoscopic ultrasonography.Gastrointest Endosc. 1993; 39: 375-383
- Carcinoid tumors: an analysis of Japanese series.J EXP Clin Cancer Res. 1985; 4: 233-244
- Carcinoma of the papilla of Vater.Aust N Z J Surg. 1982; 52: 44-47
- Primary lymphoma of the major duodenal papilla.Cancer. 1994; 73: 2083-2086
- Follicle center lymphoma of the major duodenal papilla presenting with jaundice: report of a case.Am J Surg Pathol. 1997; 21: 484-488
- A case of adenofibromatous hyperplasia of the major duodenal papilla hardly differentiated from carcinoma.Korean J Gastroenterol. 1993; 25 ([in Korean with English abstract]): 1333-1336
- Biliary obstruction arid pancreatitis caused by Brunner's gland hyperplasia of the major duodenal papilla: a case report and review of the literature.Endoscopy. 2000; 32: 998-1001
Article info
Publication history
Accepted:
August 7,
2001
Received in revised form:
July 12,
2001
Received:
March 5,
2001
Footnotes
☆Reprint requests: Myung-Hwan Kim, MD, Department of Internal Medicine, Asan Medical Center, 388-1 Poongnapdong, Songpagu, Seoul 13 8-040, Korea.
Identification
Copyright
© 2001 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.