2020 Volume 34 Issue 4 Pages 758-763
A 64-year-old man was pointed out a 10mm sized minor papilla tumor by esophagogastroduodenoscopy of medical examination. With endoscopic ultrasound-guided fine needle aspiration, the diagnosis was not confirmed, so endoscopic minor papilla resection was performed. Histopathology diagnosed neuroendocrine tumor (NET) G1 with insulinoma-associated 1 (+), mitotic index 0 / 10HPF, Ki-67 Labeling Index < 1 %, and resection margin was positive and infiltrated to muscularis propria. Therefore, subtotal stomach-preserving pancreaticoduodenectomy was performed and pathologically surgical margin was negative, lymph node metastasis at No.6,14,7b were observed. A minor papilla NET probably causes lymph node metastasis even if the tumor is less than 10mm, so regardless of the tumor size, pancreaticoduodenectomy and standard lymph node dissection is appropriate treatment.
