A 56-year-old woman was found to have a tumor of 2 cm in size on the pancreatic side of the descending part of the duodenum on upper gastrointestinal endoscopy. Abdominal CT showed a 2-cm, well-defined nodule with a poor contrast effect, and a swollen lymph node suspected to be due to lymph node metastasis around the head of the pancreas. Endoscopic ultrasonography (EUS) showed a low echo mass with an irregular margin in the third layer. EUS-guided biopsy led to diagnosis of this region as neuroendocrine neoplasm (NEN), and pancreaticoduodenectomy was performed. Histopathological examination revealed that the tumor had grown just below the mucosa of the accessory papilla of the duodenum and surrounded the accessory pancreatic duct, leading to diagnosis of NEN derived from the accessory papilla of the duodenum. Metastasis of NEN to lymph nodes around the head of the pancreas was also diagnosed. The postoperative course was uneventful and the patient was discharged 22 days after the operation. Most duodenal NEN occurs in the bulb and descending region, whereas NEN in the accessory papilla of the duodenum is rare, with an incidence of only 2.2%. However, NEN derived from the accessory papilla has a high risk of lymph node metastasis, even if the tumor diameter is small. We report a case of resection of NEN of the accessory papilla of the duodenum.
"},{"@language":"ja","@value":"症例は56歳の女性で，健康診断で施行した上部消化管内視鏡検査にて十二指腸下行部副乳頭領域に2 cm大の腫瘍を指摘された．腹部CTでは造影早期に濃染する2 cm大の境界明瞭な結節として認められ，膵頭部周囲にリンパ節転移を疑う腫大したリンパ節を認めた．Endoscopic ultrasonography（以下，EUSと略記）では第3層に2 cm弱の辺縁不整な低エコー腫瘤を認めた．EUSガイド下生検で十二指腸原発の神経内分泌腫瘍（neuroendocrine neoplasm；以下，NENと略記）と診断され，膵頭十二指腸切除術を施行した．病理組織学的検査で腫瘍は十二指腸副乳頭粘膜直下および副膵管を囲むように発育しており十二指腸副乳頭原発NENと診断した．膵頭部周囲のリンパ節には転移を認めた．術後経過は良好で，術後22日目に退院となった．十二指腸NENの発生部位は球部や下行部が大半を占め，副乳頭部は2.2%とまれである．また，十二指腸副乳頭NENは腫瘍径が小さくてもリンパ節転移を高率に伴うことが報告されている．今回，副乳頭原発NENの切除例を経験したため報告する．
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Ｒｅｃｋｌｉｎｇｈａｕｓｅｎ病の１例"}]},{"@id":"https://cir.nii.ac.jp/crid/1390282679826994560","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@language":"en","@value":"A CASE OF CARCINOID OF THE ACCESSORY PAPILLA OF DUODENUM"},{"@value":"十二指腸副乳頭カルチノイドの1例"}]},{"@id":"https://cir.nii.ac.jp/crid/1390282679828214656","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@language":"en","@value":"A case of neuroendocrine tumor in the accessory papilla of the duodenum"},{"@value":"十二指腸副乳頭神経内分泌腫瘍の1例"},{"@language":"ja-Kana","@value":"ショウレイ ジュウニシチョウ フクニュウトウ シンケイ ナイブンピ シュヨウ ノ 1レイ"}]},{"@id":"https://cir.nii.ac.jp/crid/1390282679893301248","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@language":"en","@value":"A Case of Carcinoid of Accessory Papilla of the 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(Part-II)"},{"@language":"ja","@value":"ファーター乳頭部, 小乳頭, 傍乳頭部憩室, Promontory に関する形態学的研究 (後編) 小乳頭, 傍乳頭部憩室および Promontory の 特に加令による変化および膵•胆道病変との関連について"}]},{"@id":"https://cir.nii.ac.jp/crid/1390845713007852544","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@language":"ja","@value":"十二指腸副乳頭原発カルチノイドの1例"},{"@value":"症例 十二指腸副乳頭原発カルチノイドの1例"},{"@language":"ja-Kana","@value":"ショウレイ ジュウニシチョウ フクニュウトウ ゲンパツ カルチノイド ノ 1レイ"}]},{"@id":"https://cir.nii.ac.jp/crid/1390845713015733120","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@language":"ja","@value":"十二指腸副乳頭原発神経内分泌腫瘍の1例"},{"@language":"en","@value":"A Case of Neuroendocrine Tumor of the Minor Duodenal Papilla"},{"@value":"症例 十二指腸副乳頭原発神経内分泌腫瘍の1例"},{"@language":"ja-Kana","@value":"ショウレイ ジュウニシチョウ フクニュウトウ ゲンパツ シンケイ ナイブンピ シュヨウ ノ 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