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. 1989 May;209(5):593–599. doi: 10.1097/00000658-198905000-00012

Villous tumors of the duodenum.

C W Chappuis 1, F C Divincenti 1, I Cohn Jr 1
PMCID: PMC1494062  PMID: 2650645

Abstract

Five cases of villous tumors of the duodenum are reported, all of which involve the ampulla of Vater. Three of the five lesions contained either infiltrating carcinoma or carcinoma in situ. Although preoperative endoscopic biopsy was performed on all tumors no malignancy was identified. Frozen sections done at the time of operation on the three patients with carcinoma also failed to identify malignancy. One patient underwent pancreaticoduodenectomy and four patients had local excision of the tumor. Three of the patients treated with local excision developed recurrence and two subsequently had pancreaticoduodenectomy. Because of the difficulty in making an accurate diagnosis and the chance of recurrence when local excision is employed, strong consideration should be given to pancreaticoduodenectomy as the initial form of treatment of these lesions.

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Selected References

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  1. Bluth E. I., Merritt C. R., Sullivan M. A. Ultrasonic evaluation of the stomach, small bowel, and colon. Radiology. 1979 Dec;133(3 Pt 1):677–680. doi: 10.1148/133.3.677. [DOI] [PubMed] [Google Scholar]
  2. Braasch J. W. Pancreaticoduodenal resection. Curr Probl Surg. 1988 May;25(5):321–363. doi: 10.1016/0011-3840(88)90025-1. [DOI] [PubMed] [Google Scholar]
  3. Bringaze W. L., 3rd, Chappuis C. W., Correa P., Cohn I., Jr Early gastric cancer. 21-year experience. Ann Surg. 1986 Aug;204(2):103–107. doi: 10.1097/00000658-198608000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. CATTELL R. B., BRAASCH J. W., KAHN F. Polypoid epithelial tumors of the bile ducts. N Engl J Med. 1962 Jan 11;266:57–61. doi: 10.1056/NEJM196201112660201. [DOI] [PubMed] [Google Scholar]
  5. 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]
  6. Deucher F., Villiger K. J. Zwei maligne degenerierte Duodenalpapilloma; 10- und 14-Jahres-Heilung nach Duodenopankreatektomie. Schweiz Med Wochenschr. 1968 Nov 16;98(46):1822–1825. [PubMed] [Google Scholar]
  7. 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]
  8. Faust H., Hartweg H., Eugenidis N. Zur Differenialdiagnose neoplastischer Prozesse im Duodenum. Fortschr Geb Rontgenstr Nuklearmed. 1972 Apr;116(4):499–508. [PubMed] [Google Scholar]
  9. Fenoglio C. M., Kaye G. I., Lane N. Distribution of human colonic lymphatics in normal, hyperplastic, and adenomatous tissue. Its relationship to metastasis from small carcinomas in pedunculated adenomas, with two case reports. Gastroenterology. 1973 Jan;64(1):51–66. [PubMed] [Google Scholar]
  10. Galandiuk S., Fazio V. W., Jagelman D. G., Lavery I. C., Weakley F. A., Petras R. E., Badhwar K., McGonagle B., Eastin K., Sutton T. Villous and tubulovillous adenomas of the colon and rectum. A retrospective review, 1964-1985. Am J Surg. 1987 Jan;153(1):41–47. doi: 10.1016/0002-9610(87)90199-1. [DOI] [PubMed] [Google Scholar]
  11. Galandiuk S., Hermann R. E., Jagelman D. G., Fazio V. W., Sivak M. V. Villous tumors of the duodenum. Ann Surg. 1988 Mar;207(3):234–239. doi: 10.1097/00000658-198803000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Geier G. E., Gashti E. N., Houin H. P., Johnloz D., Madura J. A. Villous adenoma of the duodenum. A clinicopathologic study of five cases. Am Surg. 1984 Nov;50(11):617–622. [PubMed] [Google Scholar]
  13. 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]
  14. Haglund U., Fork F. T., Genell S., Rehnberg O. Villous adenomas in the duodenum. Br J Surg. 1985 Jan;72(1):26–27. doi: 10.1002/bjs.1800720112. [DOI] [PubMed] [Google Scholar]
  15. Hasleton P. S., Shah S., Buckley C. H., Tweedle D. E. Ampullary carcinoma associated with multiple duodenal villous adenomas. Am J Gastroenterol. 1980 May;73(5):418–422. [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. Herbsman H., Wetstein L., Rosen Y., Orces H., Alfonso A. E., Iyer S. K., Gardner B. Tumors of the small intestine. Curr Probl Surg. 1980 Mar;17(3):121–182. doi: 10.1016/s0011-3840(80)80018-9. [DOI] [PubMed] [Google Scholar]
  18. Hinder R. A., Levy J. I., Hamilton D. G. A villous tumour of the duodenum with malignant change in a child: A case report. S Afr Med J. 1980 Jul 12;58(2):85–88. [PubMed] [Google Scholar]
  19. Hsueh Y. S., Huang T. Y., Milos R. J. Primary adenocarcinoma of the duodenum arising from villous adenoma. J Indiana State Med Assoc. 1983 Nov;76(11):770–772. [PubMed] [Google Scholar]
  20. 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]
  21. 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]
  22. Lehnert T., Erlandson R. A., Decosse J. J. Lymph and blood capillaries of the human gastric mucosa. A morphologic basis for metastasis in early gastric carcinoma. Gastroenterology. 1985 Nov;89(5):939–950. doi: 10.1016/0016-5085(85)90192-1. [DOI] [PubMed] [Google Scholar]
  23. Lewis J. H., Shorb P. E., Nochomovitz L. E. Benign duodenal villous adenoma obstructing the ampulla of Vater: a surgical dilemma. South Med J. 1985 Dec;78(12):1507–1511. doi: 10.1097/00007611-198512000-00025. [DOI] [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. Moore E. L., Potts D. W. Villous tumors of the duodenum (also case report). J Okla State Med Assoc. 1977 Nov;70(11):481–488. [PubMed] [Google Scholar]
  27. OH C., JEMERIN E. E. BENIGN ADENOMATOUS POLYPS OF THE PAPILLA OF VATER. Surgery. 1965 Apr;57:495–503. [PubMed] [Google Scholar]
  28. Perzin K. H., Bridge M. F. Adenomas of the small intestine: a clinicopathologic review of 51 cases and a study of their relationship to carcinoma. Cancer. 1981 Aug 1;48(3):799–819. doi: 10.1002/1097-0142(19810801)48:3<799::aid-cncr2820480324>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
  29. Pollak E. W., Crow J., Jacobs W. H., Choctaw W. T. Villous duodenal adenoma. A less aggressive approach. J Kans Med Soc. 1981 May;82(5):231–232. [PubMed] [Google Scholar]
  30. 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]
  31. Rosenberg J., Welch J. P., Pyrtek L. J., Walker M., Trowbridge P. Benign villous adenomas of the ampulla of Vater. Cancer. 1986 Oct 1;58(7):1563–1568. doi: 10.1002/1097-0142(19861001)58:7<1563::aid-cncr2820580730>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  32. Ryan D. P., Schapiro R. H., Warshaw A. L. Villous tumors of the duodenum. Ann Surg. 1986 Mar;203(3):301–306. doi: 10.1097/00000658-198603000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. 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]
  34. Shinya H., Wolff W. I. Morphology, anatomic distribution and cancer potential of colonic polyps. Ann Surg. 1979 Dec;190(6):679–683. doi: 10.1097/00000658-197912000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Siegel J. H., Yatto R. P. Endoscopic evaluation and therapy of periampullary adenoma. Am J Gastroenterol. 1983 Apr;78(4):225–226. [PubMed] [Google Scholar]
  36. 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]
  37. Spira I. A., Wolff W. I. Villous tumors of the duodenum. Am J Gastroenterol. 1977 Jan;67(1):63–68. [PubMed] [Google Scholar]
  38. Taxier M., Sivak M. V., Jr, Cooperman A. Villous adenoma of the ampulla of Vater. Gastrointest Endosc. 1979 Nov;25(4):155–156. doi: 10.1016/s0016-5107(79)73408-0. [DOI] [PubMed] [Google Scholar]
  39. Weiss J. B., Semerdjian G. G. Recurrent villous adenoma of the duodenum. Gastroenterology. 1986 Feb;90(2):440–442. doi: 10.1016/0016-5085(86)90945-5. [DOI] [PubMed] [Google Scholar]
  40. Welch J. P., Welch C. E. Villous adenomas of the colorectum. Am J Surg. 1976 Feb;131(2):185–191. doi: 10.1016/0002-9610(76)90095-7. [DOI] [PubMed] [Google Scholar]

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