A case of periampullary adenomyoma that potentially obviated the need for pancreaticoduodenectomy

  • Hirose Haruto
    Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital
  • Sasaki Akiko
    Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital
  • Ichita Chikamasa
    Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital
  • Sumida Chihiro
    Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital
  • Nishino Takashi
    Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital
  • Nagayama Miki
    Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital
  • Makazu Makomo
    Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital
  • Kimura Karen
    Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital
  • Masuda Sakue
    Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital
  • Naito Wataru
    Department of Diagnostic Pathology, Shonan Kamakura General Hospital
  • Tesihma Shinichi
    Department of Diagnostic Pathology, Shonan Kamakura General Hospital
  • Koizumi Kazuya
    Department of Gastroenterology Medicine Center, Shonan Kamakura General Hospital

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Other Title
  • 膵頭十二指腸切除術を回避し得た傍乳頭部のAdenomyoma

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Description

<p>Pancreaticoduodenectomy (PD) is the standard treatment for duodenal cancers suspected of submucosal invasion. Pathological diagnosis from duodenal biopsy samples has some limitations. We present the case of a man in his 70s with bile duct dilation and a suspected parapapillary duodenal cancer. Given the uncertainty of the biopsy, endoscopic submucosal dissection (ESD) was performed as a minimally invasive diagnostic alternative to PD. Histological diagnosis revealed an adenomyoma with high-grade adenoma, underscoring the efficacy of ESD in accurately diagnosing periampullary lesions. For patients with periampullary lesions, this case suggests that ESD could serve as a less invasive approach, potentially avoiding overtreatment, such as radical surgery.</p>

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