Korean J Med.
2014 Mar;86(3):319-324. 10.3904/kjm.2014.86.3.319.
A Large Neuroendocrine Tumor of the Major Duodenal Papilla Removed by Endoscopic Papillectomy
- Affiliations
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- 1Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. mhkim@amc.seoul.kr
- 2Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- KMID: 1867362
- DOI: http://doi.org/10.3904/kjm.2014.86.3.319
Abstract
- Neuroendocrine tumors (NET) of the major duodenal papilla are rare and the natural history of this disease is not clear. We experienced a case in a 31-year-old male. Duodenoscopy revealed an enlarged major duodenal papilla with central umbilication and nodularity. Endoscopic ultrasonography (EUS) demonstrated a 3-cm hypoechoic mass that was confined to the submucosa. A biopsy led to the diagnosis of a grade 1 NET. The patient refused surgery, so we performed an endoscopic papillectomy. The tumor was removed completely. The resected specimen confirmed the diagnosis of a well-differentiated NET and all resection margins were negative. Surgical resection is currently considered to be the gold standard for the treatment of a large NET of the major duodenal papilla; however, endoscopic resection is a possible treatment modality for patients at high surgical risk or who are reluctant to undergo surgery.
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