The patient is a 60 years old woman, She had an epigastric discomfort in late March, 2010. She was admitted to our hospital in 2 April, 2010. The upper gastrointestinal endoscopy was performed in 16 April. It showed hemorrhgic polypoid lesions with a white granulated duodenal papilla. The specimen showed tubulovillous adenoma.Then abdominal CT scan, endoscopic retrograde cholangiopancreatography, intraductal ultrasonography were performed, which not showed the infiltration of the pancreas.Endoscopic snare papillectomy for tumors of the duodenal papilla was performed 20 May, 2010. There were no postoperative complications including pancreatitis, bleeding, perforation. The histopathologic diagnosis was tubulovillous adenoma.
In recent years, technology in endoscopy has advanced, IDUS and EUS for ampullary lesions has become possible for more diagnostics.Endoscopic therapy appears to be a reasonable alternative to surgery for management of papillary tumors.
