-Case Reports-

Adenocarcinoma of the Minor Duodenal Papilla: Report of a Case

Arichika Hoshino¹, Yoshiharu Nakamura², Hideyuki Suzuki¹, Satoshi Mizutani¹, Hideaki Ishii³, Masanori Watanabe¹, Hideki Bou¹, Masanori Yoshino¹, Osamu Komine¹ and Eiji Uchida²

¹Institute of Gastroenterology, Nippon Medical School Musashi Kosugi Hospital
²Department of Surgery, Nippon Medical School
³Department of Pathology, Nippon Medical School Musashi Kosugi Hospital

We report a rare case of adenocarcinoma of the minor papilla of the duodenum treated with transduodenal minor papillectomy. A 64-year-old woman was treated for an asymptomatic duodenal tumor detected on gastroduodenoscopy. Endoscopy showed a 15-mm sessile mass in the descending duodenum proximal to the major papilla. The major papilla was a villous 24-mm-diameter polypoid tumor. Histopathologic examination of the biopsy specimen showed tubular adenoma with moderate epithelial atypia. Transduodenal major and minor papillectomies were performed. The orifice of the duct of Santorini and the pancreatic duct were re-approximated to the duodenal wall to prevent acute pancreatitis caused by scarring and stenosis of the duct orifice. Histological findings were consistent with well-differentiated adenocarcinoma limited to the minor duodenal papilla, without infiltration of the duodenal wall submucosa, and confirmed complete resection. The patient had an uneventful postoperative course and has remained asymptomatic, without evidence of tumor recurrence or stenosis of the pancreatic duct orifice, for 4 years.

J Nippon Med Sch 2013; 80: 165-170

Keywords
adenocarcinoma, minor papilla, transduodenal minor papillectomy

Correspondence to
Arichika Hoshino, Institute of Gastroenterology, Nippon Medical School Musashi Kosugi Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan
kuma-3@momo.so-net.ne.jp

Received, August 29, 2012
Accepted, December 21, 2012