Authors
Eisuke Ozawa, Takuji Yamao, Kosuke Takahashi, Mizuki Kitagawa, Masashi Shibata, Satoshi Miuma, Keisuke Iwasaki, Hisamitsu Miyaaki
Published in
Clinical journal of gastroenterology. Sep 06, 2026. Epub Sep 06, 2026.
Abstract
Adenocarcinoma of the minor duodenal papilla is rare, and most previously reported cases have been treated by pancreaticoduodenectomy. An 82-year-old woman underwent endoscopy for anemia, which revealed a granular, flat-elevated lesion in the descending duodenum, 2 cm proximal to the major papilla. Endoscopic retrograde pancreatography showed leakage of contrast medium from the orifice of the accessory pancreatic duct at the lesion, confirming a tumor of the minor papilla. The initial biopsy showed adenoma, and the lesion was followed. Six months later it had enlarged and become friable, and repeat biopsy was suspicious for adenocarcinoma. Because pancreaticoduodenectomy was considered too invasive given her age and comorbidities, and because the minor papilla-unlike the major papilla-can be lifted by submucosal injection, en-bloc endoscopic mucosal resection was performed for both diagnostic and therapeutic purposes. Histology showed well-differentiated adenocarcinoma arising in adenoma, confined to the mucosa, with tumor-free margins and no lymphovascular invasion. No adverse events occurred, and no recurrence was observed during approximately 5 years of follow-up (endoscopic surveillance up to 2 years); the patient later died of an unrelated cause. Endoscopic mucosal resection may be a minimally invasive option achieving histologically complete resection in selected intramucosal carcinomas of the minor duodenal papilla.
PMID:
42701934
Bibliographic data and abstract were imported from PubMed on 07 Sep 2026.
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