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Vega Novillo V, García Picazo A, Cámara M, Jiménez C, Justo Alonso I. Adenomyomatous hiperplasia of the vateryan system. Cir Esp 2023; 101:869-874. [PMID: 36933891 DOI: 10.1016/j.cireng.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 11/10/2022] [Accepted: 12/09/2022] [Indexed: 03/18/2023]
Affiliation(s)
- Viviana Vega Novillo
- Servicio de Cirugía General del Aparato Digestivo y de Trasplantes de órganos abdominales, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain.
| | - Alberto García Picazo
- Servicio de Cirugía General del Aparato Digestivo y de Trasplantes de órganos abdominales, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
| | - María Cámara
- Servicio de Cirugía General del Aparato Digestivo y de Trasplantes de órganos abdominales, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
| | - Carlos Jiménez
- Servicio de Cirugía General del Aparato Digestivo y de Trasplantes de órganos abdominales, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
| | - Iago Justo Alonso
- Servicio de Cirugía General del Aparato Digestivo y de Trasplantes de órganos abdominales, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
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Libeert A, Mutluoglu M, Trenson F, Gryspeerdt S. When Aunt Minnie turns out to be a Zebra: distal bile duct adenomyoma stimulating pancreas head tumor. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2023; 115:458. [PMID: 36263806 DOI: 10.17235/reed.2022.9240/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A 55-year-old female patient with a history of ethyl and nicotine abuse presented with chronic diarrhoea, significant weight loss and abnormal liver tests. Ultrasound examination revealed dilatation of the bile ducts and computed tomography scan with IV contrast further established simultaneous dilatation of the common bile duct and pancreatic duct (double duct sign). The dilatation abruptly stopped at the level of the pancreatic head which demonstrated a small irregular hypovascular zone (1.2 cm), suspected for malignancy. The following week, a radical pancreaticoduodenectomy was performed. Anatomopathological analysis revealed an adenomyoma (12 mm) located distal to the common bile duct, without arguments for malignancy.
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Frutuoso L, Pereira AM, Carvalho L, Gonçalves G, Nora M. Adenomyomatous Hyperplasia of Ampulla of Vater and a Concomitant Renal Tumor: A Case Report. Cureus 2021; 13:e20258. [PMID: 35018260 PMCID: PMC8739335 DOI: 10.7759/cureus.20258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2021] [Indexed: 11/05/2022] Open
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Park Y, Lee J, Kim Y, Cho BS, Park KS, Woo CG. Differentiation of Adenomyoma from Localized Adenocarcinoma of the Ampulla of Vater Using Multidetector CT. TAEHAN YONGSANG UIHAKHOE CHI 2021; 82:393-405. [PMID: 36238730 PMCID: PMC9431932 DOI: 10.3348/jksr.2020.0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/25/2020] [Accepted: 06/11/2020] [Indexed: 11/30/2022]
Abstract
Purpose To determine the multidetector CT (MDCT) findings that differentiate adenomyoma of the ampulla of Vater (AOV) from localized adenocarcinoma of the AOV. Materials and Methods Sixteen and 30 patients with adenomyoma and localized adenocarcinoma of the AOV, respectively, were evaluated using MDCT. We analyzed the size and attenuation value and presence of uniform enhancement of the lesions, diameters of the extrahepatic bile duct (EHD) and main pancreatic duct, presence of regional lymph node enlargement, and laboratory findings. We determined the independent findings for differentiating adenomyoma from localized adenocarcinoma of the AOV using multivariate analysis. Results The size of the lesion and diameter of the EHD were significantly smaller for adenomyoma than those for localized adenocarcinoma of the AOV (all p < 0.001). In multivariate analyses, a lesion size of ≤ 1.3 cm, an EHD diameter of ≤ 1.3 cm, and an alanine transaminase level of ≤ 31 IU/L significantly differentiated adenomyoma from localized adenocarcinoma of the AOV. When all of these three findings were met, the specificity for adenomyoma of the AOV was 93.3%. Conclusion MDCT imaging may facilitate the differential diagnosis of adenomyoma and localized adenocarcinoma of the AOV based on the size of the lesion and diameter of the EHD.
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Ramos-Muñoz F, Hinojosa-Arco LC, Roldán-de la Rúa JF, García-Salguero AI, Suárez-Muñoz MÁ. Bile duct obstruction due to adenomyoma of the ampulla of Vater. GASTROENTEROLOGIA Y HEPATOLOGIA 2020; 45 Suppl 1:69-70. [PMID: 33211648 DOI: 10.1016/j.gastrohep.2020.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 10/08/2020] [Accepted: 10/15/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Francisco Ramos-Muñoz
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España.
| | - Luis Carlos Hinojosa-Arco
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | | | | | - Miguel Ángel Suárez-Muñoz
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
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Gouveia C, Fidalgo C, Loureiro R, Oliveira H, Maio R, Cravo M. Adenomyomatosis of the Common Bile Duct and Ampulla of Vater. GE-PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2020; 28:121-133. [PMID: 33791399 DOI: 10.1159/000507788] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 04/06/2020] [Indexed: 01/03/2023]
Abstract
Adenomyomatosis is a rare benign lesion that has been observed in different sites throughout the gastrointestinal tract, most frequently in the gallbladder. Few cases have been described in the stomach, small bowel, bile ducts, and ampullary region. Adenomyomas of the vaterian system (ampulla and common bile duct) have important clinical consequences, since the majority of these lesions present with biliary tract obstruction and mimic malignant behavior. As a consequence, considering the diagnostic difficulty of these lesions, patients are often treated with extensive surgery (pancreaticoduodenectomy). We report 2 cases of adenomyomatosis: one of the ampulla of Vater and the other of the common bile duct, as well as a review of reported cases in the literature. Both of our patients presented with epigastralgia and had laboratory or endoscopic evidence of biliary obstruction. Both patients underwent endoscopic ultrasound, one of them with fine-needle aspiration; however, it was not possible to exclude the possibility of cancer. The diagnosis of adenomyoma was only confirmed by the surgical specimen after pancreaticoduodenectomy.
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Affiliation(s)
- Catarina Gouveia
- Gastroenterology Department, Beatriz Ângelo Hospital, Loures, Portugal
| | - Catarina Fidalgo
- Gastroenterology Department, Beatriz Ângelo Hospital, Loures, Portugal
| | - Rui Loureiro
- Gastroenterology Department, Beatriz Ângelo Hospital, Loures, Portugal
| | - Helena Oliveira
- Pathology Department, Beatriz Ângelo Hospital, Loures, Portugal
| | - Rui Maio
- General Surgery Department, Beatriz Ângelo Hospital, Loures, Portugal
| | - Marília Cravo
- Gastroenterology Department, Beatriz Ângelo Hospital, Loures, Portugal
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Xu LM, Hu DM, Tang W, Wei SH, Chen W, Chen GQ. Adenomyoma of the distal common bile duct demonstrated by endoscopic ultrasound: A case report and review of the literature. World J Clin Cases 2019. [DOI: 10.12998/wjcc.v7.i21.3598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Beyna T, Gerges C, Esposito I, Neuhaus H. Endobiliary polypectomy of biliary tumor using a prototype dedicated cholangioscope with double-bending technology. VideoGIE 2018; 3:386-389. [PMID: 30506003 PMCID: PMC6251704 DOI: 10.1016/j.vgie.2018.08.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Torsten Beyna
- Department of Gastroenterology, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany
| | - Christian Gerges
- Department of Gastroenterology, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany
| | - Irene Esposito
- Institute of Pathology, Heinrich-Heine University and University Hospital of Düsseldorf, Düsseldorf, Germany
| | - Horst Neuhaus
- Department of Gastroenterology, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany
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Gialamas E, Mormont M, Bagetakos I, Frossard JL, Morel P, Puppa G. Combination of Adenomyoma and Adenomyomatous Hyperplasia of the Ampullary System: A First Case Report. Int J Surg Pathol 2018; 26:644-648. [PMID: 29618230 DOI: 10.1177/1066896918767561] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adenomyoma and adenomyomatous hyperplasia are benign tumor-like lesions that rarely involve the major or minor duodenal papilla. We report the case of a 73-year-old patient who underwent a cephalic duodenopancreatectomy due to clinical and radiological evidence of underlying malignant neoplasm. The histopathology results revealed the unusual association of a major duodenal papilla adenomyoma and an adenomyomatous hyperplasia of the minor papilla. Because of their resemblance to pancreatic malignancy, the diagnosis of these lesions is particularly challenging. In most cases, it is established postoperatively, after histopathological examination of the surgical specimen.
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Affiliation(s)
- Eleftherios Gialamas
- 1 Division of Abdominal Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Murielle Mormont
- 1 Division of Abdominal Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Ilias Bagetakos
- 2 Department of Radiology, Geneva University Hospitals, Switzerland
| | - Jean-Louis Frossard
- 3 Division of Gastroenterology and Hepatology, Geneva University Hospitals, Switzerland
| | - Philippe Morel
- 1 Division of Abdominal Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Giacomo Puppa
- 4 Department of Clinical Pathology, Geneva University Hospitals, Faculty of Medicine, Switzerland
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Lee HS, Jang JS, Lee S, Yeon MH, Kim KB, Park JG, Lee JY, Kim MJ, Han JH, Sung R, Park SM. Diagnostic Accuracy of the Initial Endoscopy for Ampullary Tumors. Clin Endosc 2015; 48:239-46. [PMID: 26064825 PMCID: PMC4461669 DOI: 10.5946/ce.2015.48.3.239] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 08/04/2014] [Accepted: 08/05/2014] [Indexed: 12/30/2022] Open
Abstract
Background/Aims Ampullary tumors come in a wide variety of malignant forms. We evaluated the diagnostic accuracy of endoscopy for ampullary tumors, and analyzed the causes of misdiagnosis. Methods We compared endoscopic imaging and biopsy results to final diagnoses. Types of endoscope, numbers of biopsy specimens taken, and final diagnoses were evaluated as possible factors influencing diagnostic accuracy. Results Final diagnoses were 19 adenocarcinomas, 18 normal or papillitis, 11 adenomas, two adenomyomas, one paraganglioma, and one neuroendocrine tumor. The diagnostic accuracy of endoscopic imaging or the initial biopsy was identical (67.3%). At least one test was concordant with the final diagnosis in all except two cases. Compared with the final diagnosis, endoscopic imaging tended to show more advanced tumors, whereas the initial biopsy revealed less advanced lesions. The diagnostic accuracy of the initial biopsy was influenced by the type of endoscope used and the final diagnosis, but not by the number of biopsies taken. Conclusions Endoscopy has limited accuracy in the diagnosis of ampullary tumors. However, most cases with concordant endoscopic imaging and biopsy results are identical to the final diagnosis. Therefore, in cases where both of these tests disagree, re-evaluation with a side-viewing endoscope after resolution of papillitis is required.
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Affiliation(s)
- Hee Seung Lee
- Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jong Soon Jang
- Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Seungho Lee
- Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Myeong Ho Yeon
- Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Ki Bae Kim
- Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jae Geun Park
- Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Joo Young Lee
- Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Mi Jin Kim
- Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Joung-Ho Han
- Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Rohyun Sung
- Department of Pathology, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Seon Mee Park
- Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea
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Kim HJ, Kim JS. [Necessity of histologic confirmation for adequate management in ampullary tumors]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2014; 62:315-6. [PMID: 24505821 DOI: 10.4166/kjg.2013.62.6.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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