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Korean J Med > Volume 86(3); 2014 > Article
The Korean Journal of Medicine 2014;86(3): 319-324.
내시경 유두절제술로 제거한 거대 십이지장 주유두의 신경내분비종양
배승현1, 김진용1, 김창래1, 최영권1, 신보미1, 홍승모2, 김명환1
1울산대학교 의과대학 서울아산병원 내과
2울산대학교 의과대학 서울아산병원 병리과
A Large Neuroendocrine Tumor of the Major Duodenal Papilla Removed by Endoscopic Papillectomy
Seung-Hyeon Bae1, Jin Yong Kim1, Chang Lae Kim1, Young Kwon Choi1, Bo Mi Shin1, Seung-Mo Hong2, Myung-Hwan Kim1
1Departments of 1Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Departments of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Corresponding Author: Myung-Hwan Kim ,Tel: +82-2-3010-3183, Fax: +82-2-3010-0824, Email: mhkim@amc.seoul.kr
Received: April 17, 2013;   Revised: April 23, 2013;   Accepted: May 9, 2013.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Neuroendocrine tumors (NET) of the major duodenal papilla are rare and the natural history of this disease is not clear. We experienced a case in a 31-year-old male. Duodenoscopy revealed an enlarged major duodenal papilla with central umbilication and nodularity. Endoscopic ultrasonography (EUS) demonstrated a 3-cm hypoechoic mass that was confined to the submucosa. A biopsy led to the diagnosis of a grade 1 NET. The patient refused surgery, so we performed an endoscopic papillectomy. The tumor was removed completely. The resected specimen confirmed the diagnosis of a well-differentiated NET and all resection margins were negative. Surgical resection is currently considered to be the gold standard for the treatment of a large NET of the major duodenal papilla; however, endoscopic resection is a possible treatment modality for patients at high surgical risk or who are reluctant to undergo surgery. (Korean J Med 2014;86:319-324)
Keywords: Neuroendocrine tumors; Major duodenal papilla
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