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. 1986 Mar;203(3):301–306. doi: 10.1097/00000658-198603000-00015

Villous tumors of the duodenum.

D P Ryan, R H Schapiro, A L Warshaw
PMCID: PMC1251095  PMID: 3954483

Abstract

Nineteen cases of villous tumors of the duodenum are reported. They have a predilection for the ampullary region, tend to present with obstructive jaundice, especially if malignancy is present, and have a high prevalence of cancer (12 of 19, or 63%). Even when biopsies are available, the diagnosis of cancer is frequently missed (5 of 9 proven cancers, 56% false-negative rate), and it may be impossible to assess the presence of carcinoma in situ or invasive carcinoma without complete excision of the lesion. The authors' experience suggests that some small benign ampullary villous adenomas or those with carcinoma in situ can be excised locally but that pancreaticoduodenectomy is preferable in the fit patient for better local control both of extensive benign lesions and cancers without distant metastases.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Crane J. M., Gobbel W. G., Jr, Scott H. W., Jr Surgical experience with malignant tumors of the ampulla of vater and duodenum. Surg Gynecol Obstet. 1973 Dec;137(6):937–940. [PubMed] [Google Scholar]
  2. DARLING R. C., WELCH C. E. Tumors of the small intestine. N Engl J Med. 1959 Feb 26;260(9):397–408. doi: 10.1056/NEJM195902262600901. [DOI] [PubMed] [Google Scholar]
  3. Everett G. D., Shirazi S. S., Mitros F. A. Villous tumors of the duodenum. Report of two cases. Am J Gastroenterol. 1981 May;75(5):376–379. [PubMed] [Google Scholar]
  4. Griffen W. O., Jr, Schaefer J. W., Schindler S., Hyde G., Bryant L. R. Ampullary obstruction by benign duodenal polyps. Arch Surg. 1968 Sep;97(3):444–449. doi: 10.1001/archsurg.1968.01340030104009. [DOI] [PubMed] [Google Scholar]
  5. Kalmar J. A., Merritt C. R. Villous adenoma of the duodenum with intussusception. South Med J. 1980 May;73(5):651–653. doi: 10.1097/00007611-198005000-00029. [DOI] [PubMed] [Google Scholar]
  6. Komorowski R. A., Cohen E. B. Villous tumors of the duodenum: a clinicopathologic study. Cancer. 1981 Mar 15;47(6):1377–1386. doi: 10.1002/1097-0142(19810315)47:6<1377::aid-cncr2820470623>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
  7. Kutin N. D., Ranson J. H., Gouge T. H., Localio S. A. Villous tumors of the duodenum. Ann Surg. 1975 Feb;181(2):164–168. doi: 10.1097/00000658-197502000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Moss W. M., McCart P. M., Juler G., Miller D. R. Primary adenocarcinoma of the duodenum. Arch Surg. 1974 Jun;108(6):805–807. doi: 10.1001/archsurg.1974.01350300047013. [DOI] [PubMed] [Google Scholar]
  9. Nakao N. L., Siegel J. H., Stenger R. J., Gelb A. M. Tumors of the ampulla of Vater: early diagnosis by intraampullary biopsy during endoscopic cannulation. Two case presentations and a review of the literature. Gastroenterology. 1982 Aug;83(2):459–464. [PubMed] [Google Scholar]
  10. Ranzi T., Castagnone D., Velio P., Bianchi P., Polli E. E. Gastric and duodenal polyps in familial polyposis coli. Gut. 1981 May;22(5):363–367. doi: 10.1136/gut.22.5.363. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Reynolds R., Lloyd D. A., Sweeney J. P., Stamm B., Slinger R. P. Villous adenoma of the duodenum presenting as acute pancreatitis. J Clin Gastroenterol. 1982 Dec;4(6):533–536. doi: 10.1097/00004836-198212000-00010. [DOI] [PubMed] [Google Scholar]
  12. Ring E. J., Ferrucci J. T., Jr, Eaton S. B., Jr, Clements J. L. Villous adenomas of the duodenum. Radiology. 1972 Jul;104(1):45–48. doi: 10.1148/104.1.45. [DOI] [PubMed] [Google Scholar]
  13. Schulten M. F., Oyasu R., Beal J. M. Villous adenoma of the duodenum. A case report and review of the literature. Am J Surg. 1976 Jul;132(1):90–96. doi: 10.1016/0002-9610(76)90297-x. [DOI] [PubMed] [Google Scholar]
  14. Sobol S., Cooperman A. M. Villous adenoma of the ampulla of Vater. An unusual cause of biliary colic and obstructive jaundice. Gastroenterology. 1978 Jul;75(1):107–109. [PubMed] [Google Scholar]
  15. White S. H., Nazarian N. A., Smith A. M., Balfour T. W. Periampullary adenoma causing pancreatitis. Br Med J (Clin Res Ed) 1981 Aug 22;283(6290):527–527. doi: 10.1136/bmj.283.6290.527. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Williamson R. C., Welch C. E., Malt R. A. Adenocarcinoma and lymphoma of the small intestine. Distribution and etiologic associations. Ann Surg. 1983 Feb;197(2):172–178. doi: 10.1097/00000658-198302000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Yao T., Ida M., Ohsato K., Watanabe H., Omae T. Duodenal lesions in familial polyposis of the colon. Gastroenterology. 1977 Nov;73(5):1086–1092. [PubMed] [Google Scholar]

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