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Annals of Surgery logoLink to Annals of Surgery
. 1975 Feb;181(2):164–168. doi: 10.1097/00000658-197502000-00007

Villous tumors of the duodenum.

N D Kutin, J H Ranson, T H Gouge, S A Localio
PMCID: PMC1343747  PMID: 1111448

Abstract

Villous tumors of the duodenum are rare, but treatment may be problematic because of their association with invasive adenocarcinoma. Two cases of villous tumor of the duodenum are described and 39 other reported cases are reviewed. Presenting symptoms were bleeding 27%; obstruction 24%; jaundice 22% and vague dyspepsia 20%. Diagnosis may be made by radiographic barium contrast evaluation of the duodenum, especially with the addition of air contrast hypotonic studies and by fibro-optic endoscopy. Twenty-seven per cent of villous tumors of the duodenum are associated with adenocarcinoma. Invasive tumor is more common in patients over 50 years old (35%), in tumors of the third and fourth portions of the duodenum (44%) and in tumors over 4 cm in diameter (30%). Local excision is the treatment of choice for benign lesions. Pancreatico-duodenectomy is recommended for tumors which include invasive carcinoma in patients without distal 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. Andersen A., Iversen O., Ostberg J. Primary tumours of the duodenum. Acta Chir Scand Suppl. 1965;343:28–36. [PubMed] [Google Scholar]
  2. BERNSTEIN J. S., WOO YOON CHEY Small bowel tumors; a clinical study of 109 cases. J Mt Sinai Hosp N Y. 1958 Jan-Feb;25(1):1–28. [PubMed] [Google Scholar]
  3. BOYER C. W., Jr, HELFRICH R. B. ADENOMA OF THE DUODENAL BULB. A CASE REPORT. Am J Roentgenol Radium Ther Nucl Med. 1963 Oct;90:753–755. [PubMed] [Google Scholar]
  4. Bacon H. E., Eisenberg S. W. Papillary adenoma or villous tumor of the rectum and colon. Ann Surg. 1971 Dec;174(6):1002–1008. doi: 10.1097/00000658-197112000-00020. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bremer E. H., Battaile W. G., Bulle P. H. Villous tumors of the upper gastrointestinal tract. Clinical review and report of a case. Am J Gastroenterol. 1968 Aug;50(2):135–143. [PubMed] [Google Scholar]
  6. Bruno M. S., Fein H. D. Primary malignant and benign tumors of the duodenum. A study of 18 cases stressing the clinical and roentgenographic features. Arch Intern Med. 1970 Apr;125(4):670–679. [PubMed] [Google Scholar]
  7. CATTELL R. B., PYRTEK L. J. Premalignant lesions of the ampulla of Vater. Surg Gynecol Obstet. 1950 Jan;90(1):21-30, illust. [PubMed] [Google Scholar]
  8. CHARLES R. N., KELLEY M. L., Jr, CAMPETI F. Primary duodenal tumors. A study of 31 cases. Arch Intern Med. 1963 Jan;111:23–33. doi: 10.1001/archinte.1963.03620250027005. [DOI] [PubMed] [Google Scholar]
  9. COOLEY R. N., STEMBRIDGE V. A. Benign tumors of the stomach and duodenum; their radiologic appearance. Tex State J Med. 1955 Nov;51(11):754–764. [PubMed] [Google Scholar]
  10. 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]
  11. Dayal Y., Bass A. G., Kraft A. R., Glotzer D. J., Goldman H. Villous adenoma of the duodenum. Am J Surg. 1972 Sep;124(3):394–398. doi: 10.1016/0002-9610(72)90049-9. [DOI] [PubMed] [Google Scholar]
  12. Dwyer W. A., O'Brien R. F. Duodenal obstruction due to malignant villous adenoma. Report of a case. J Med Soc N J. 1970 Aug;67(8):477–479. [PubMed] [Google Scholar]
  13. EBERT R. E., PARKHURST G. F., MELENDY O. A., OSBORNE M. P. Primary tumors of the duodenum. Surg Gynecol Obstet. 1953 Aug;97(2):135–139. [PubMed] [Google Scholar]
  14. ENTERLINE H. T., EVANS G. W., MERCUDO-LUGO R., MILLER L., FITTS W. T., Jr Malignant potential of adenomas of colon and rectum. JAMA. 1962 Feb 3;179:322–330. doi: 10.1001/jama.1962.03050050012003. [DOI] [PubMed] [Google Scholar]
  15. Hancock R. J. An 11-year review of primary tumours of the small bowel including the duodenum. Can Med Assoc J. 1970 Nov 21;103(11):1177–1179. [PMC free article] [PubMed] [Google Scholar]
  16. Haubrich W. S., Johnson R. B., Foroozan P. Endoscopic removal of a duodenal adenoma. Gastrointest Endosc. 1973 May;19(4):201–201. doi: 10.1016/s0016-5107(73)74009-8. [DOI] [PubMed] [Google Scholar]
  17. Horn R. C., Jr Malignant potential of polypoid lesions of the colon and rectum. Cancer. 1971 Jul;28(1):146–152. doi: 10.1002/1097-0142(197107)28:1<146::aid-cncr2820280130>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  18. JOERGENSON E. J., WEIBEL L. A. A study of small bowel tumors; with special emphasis on clinical aspects. Calif Med. 1951 Dec;75(6):395–399. [PMC free article] [PubMed] [Google Scholar]
  19. JOERGENSON E. J., WEIBEL L. A., KEASBEY L. E. A clinical study of fifty-six duodenal tumors. West J Surg Obstet Gynecol. 1953 Sep;61(9):507–518. [PubMed] [Google Scholar]
  20. KIEFER E. D., CHRISTIANSEN P. A. Benign tumors of the stomach and duodenum. Med Clin North Am. 1956 Mar;40(2):381–389. doi: 10.1016/s0025-7125(16)34587-4. [DOI] [PubMed] [Google Scholar]
  21. Kenefick J. S. Carcinoma of the duodenum. Br J Surg. 1972 Jan;59(1):50–55. doi: 10.1002/bjs.1800590113. [DOI] [PubMed] [Google Scholar]
  22. Lawrence W., Jr, McNeill D. D., Jr, Cohen A., Terz J. J. Benign duodenal tumors: unusual surgical problems. Ann Surg. 1970 Dec;172(6):1015–1022. doi: 10.1097/00000658-197012000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. MOERSCH R. N., WOOLNER L. B., CLAGETT O. T. Villous adenoma of the duodenum. Surgery. 1962 May;51:574–577. [PubMed] [Google Scholar]
  24. Meltzer A. D., Ostrum B. I., Isard H. J. Villous tumors of the stomach and duodenum; report of three cases. Radiology. 1966 Sep;87(3):511–513. doi: 10.1148/87.3.511. [DOI] [PubMed] [Google Scholar]
  25. Mir-Madjlessi S. H., Farmer R. G., Hawk W. A. Villous tumors of the duodenum and jejunum. Report of four cases and review of the literature. Am J Dig Dis. 1973 Jun;18(6):467–476. doi: 10.1007/BF01076597. [DOI] [PubMed] [Google Scholar]
  26. Olson R. O., Jr, Davis W. C. Villous adenomas of the colon, benign or malignant? Arch Surg. 1969 Apr;98(4):487–492. doi: 10.1001/archsurg.1969.01340100119016. [DOI] [PubMed] [Google Scholar]
  27. Palmisano P. J., Guzzo F. P. Benign villous tumor of the duodenum. J Fla Med Assoc. 1972 Feb;59(2):35–36. [PubMed] [Google Scholar]
  28. RIVER L., SILVERSTEIN J., TOPE J. W. Benign neoplasms of the small intestine; a critical comprehensive review with reports of 20 new cases. Surg Gynecol Obstet. 1956 Jan;102(1):1–38. [PubMed] [Google Scholar]
  29. 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]
  30. Saibil E., Guttman F., Palayew M. J. Villous adenoma of the duodenum. A case report and review of the literature. J Can Assoc Radiol. 1972 Dec;23(4):257–258. [PubMed] [Google Scholar]
  31. Schorsch H. A., Gutierrez N. Villous adenoma of the duodenum. Report of a case. Am J Gastroenterol. 1965 Oct;44(4):382–384. [PubMed] [Google Scholar]
  32. Serrano J. F., McPeak C. J. Primary neoplasms of the duodenum. Surgery. 1966 Feb;59(2):199–202. [PubMed] [Google Scholar]
  33. Shah S. N., Elibol T., Aquilina J. T. Villous adenoma of the duodenum and multiple duodenal polyps. A case report. Gastrointest Endosc. 1972 May;18(4):179–180. doi: 10.1016/s0016-5107(72)74073-0. [DOI] [PubMed] [Google Scholar]
  34. Stassa G., Klingensmith W. C., 3rd Primary tumors of the duodenal bulb. Am J Roentgenol Radium Ther Nucl Med. 1969 Sep;107(1):105–110. doi: 10.2214/ajr.107.1.105. [DOI] [PubMed] [Google Scholar]
  35. Steinberg L. S., Shieber W. Villous adenomas of the small intestine. Surgery. 1972 Mar;71(3):423–428. [PubMed] [Google Scholar]
  36. WALK L. Villous tumor of the stomach; clinical review and report of two cases. AMA Arch Intern Med. 1951 Apr;87(4):560–569. doi: 10.1001/archinte.1951.03810040085006. [DOI] [PubMed] [Google Scholar]
  37. WARREN K. W. The surgical treatment of uncommon lesions of the duodenum. Surg Clin North Am. 1952 Jun;:877–898. doi: 10.1016/s0039-6109(16)33651-9. [DOI] [PubMed] [Google Scholar]
  38. Wolk D. P., Knapper W. H., Farr G. H. Brunner's gland cystadenoma of the duodenum. Am J Surg. 1973 Sep;126(3):439–440. doi: 10.1016/s0002-9610(73)80141-2. [DOI] [PubMed] [Google Scholar]

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