Korean J Pancreas Biliary Tract.  2016 Jan;21(1):29-33. 10.15279/kpba.2016.21.1.29.

Ampulla of Vater Adenomyoma with Dilatations of Biliary and Pancreatic Duct

• Kim SA
• Woo SM
• Hong EK
• Han SS
• Park SJ
• Koh YH
• Lee JH
• Lee WJ

• KMID: 2448509
• DOI: http://doi.org/10.15279/kpba.2016.21.1.29

Abstract

Adenomyoma is a non-neoplastic lesion that frequently occurs in the gallbladder, but it's rarely found at the ampulla of Vater. When it develops at the ampulla of Vater, it may be mistaken for a periampullary malignancy. A 64-year-old asymptomatic male patient visited to our hospital with abnormal sonogram findings. Abdominal computed tomography and magnetic resonance cholangiopancreatography showed dilatations of common bile duct and main pancreatic duct. However, there was no definite ampullary mass. We performed endoscopic biopsies and endoscopic ultrasonography-guided fine needle aspiration. But the results were negative for malignant cells. Because we could not completely rule out malignancy, pylorus preserving pancreato-duodenectomy was performed. Histologically, hyperplastic components are intermixed with smooth muscle fibers in the subepithelial portion of ampulla of Vater. Awareness of adenomyoma of the ampulla of Vater is very important because of their clinical and endoscopic similarities to ampullary tumors.

Keyword

Adenomyoma; Adenomyomatous hyperplasia; Ampulla of Vater

MeSH Terms

Adenomyoma*
Ampulla of Vater*
Biopsy
Biopsy, Fine-Needle
Cholangiopancreatography, Magnetic Resonance
Common Bile Duct
Dilatation*
Gallbladder
Humans
Male
Middle Aged
Muscle, Smooth
Pancreatic Ducts*
Pylorus