Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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A Case of Ampullary Adenomyoma Associated with Dilatations of Pancreatic and Biliary Ducts

췌담관 확장을 동반한 바터 팽대부 선근종 1예

  • Lee, Byung-Uk (Department of Internal Medicine, Seoul Veterans Hospital) ;
  • Bang, Jei-So (Department of Internal Medicine, Seoul Veterans Hospital) ;
  • Yang, Soo-Hyun (Department of Internal Medicine, Seoul Veterans Hospital) ;
  • Kim, Ji-Ho (Department of Internal Medicine, Seoul Veterans Hospital) ;
  • Byun, Jong-Hoon (Department of Internal Medicine, Seoul Veterans Hospital) ;
  • Si, Won-Keun (Department of Internal Medicine, Seoul Veterans Hospital) ;
  • Lee, Moon-Hyung (Department of Internal Medicine, Seoul Veterans Hospital) ;
  • Choi, Bo-Kyoung (Department of Internal Medicine, Seoul Veterans Hospital)
  • 이병욱 (서울보훈병원 소화기내과) ;
  • 방제소 (서울보훈병원 소화기내과) ;
  • 양수현 (서울보훈병원 소화기내과) ;
  • 김지호 (서울보훈병원 소화기내과) ;
  • 변종훈 (서울보훈병원 소화기내과) ;
  • 시원근 (서울보훈병원 소화기내과) ;
  • 이문형 (서울보훈병원 소화기내과) ;
  • 최보경 (서울보훈병원 소화기내과)
  • Received : 2010.03.10
  • Accepted : 2010.05.18
  • Published : 2010.06.30
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Abstract

Adenomyoma is a nonneoplastic lesion that can be found anywhere in the gastrointestinal tract, but it's rarely found in the ampulla of Vater. To the best of our knowledge, it is a benign lesion, but most cases are misdiagnosed as carcinoma or adenoma by a preoperative endoscopic or radiologic procedure, and this leads to unnecessarily extensive surgical resection. We report here on a case of ampulla of Vater adenomyoma that resulted in biliary and pancreatic duct dilatation. The tumor was diagnosed by endoscopic papillectomy.

선근종은 조직학적으로 상피조직과 평활근의 증식으로 구성된 결절성 병변이다. 대부분은 특이적 증상 없이 우연히 발견되나 담도계에서 발생하는 경우 복통 등의 증상을 유발하거나 췌담관 폐쇄를 일으키므로 악성 종양을 배제하지 못해 수술하는 경우도 있다. 저자들은 상복부 통증으로 내원한 환자에서 췌담관의 확장을 동반한 바터 팽대부 병변을 내시경 유두절제술을 하여 선근종으로 진단한 1예를 경험하여 문헌 고찰과 함께 보고한다.

Keywords

References

  1. Ulich TR, Kollin M, Simmons GE, Wilczynski SP, Waxman K. Adenomyoma of the papilla of Vater. Arch Pathol Lab Med 1987;111:388-390.
  2. Handra-Luca A, Terris B, Couvelard A, Bonte H, Flejou JF. Adenomyoma and adenomyomatous hyperplasia of the Vaterian system: clinical, pathological, and new immunohistochemical features of 13 cases. Mod Pathol 2003;16:530-536. https://doi.org/10.1097/01.MP.0000073525.71096.8F
  3. Yang S, Oh SO, Shin JA, et al. A case of adenomyoma in distal common bile duct. Korean J Med 2007;72:217-221.
  4. Park JH, Kim YJ, Kim HK, et al. A case of adenomyoma of duodenum. Korean J Gastrointest Endosc 1997;17:200-203.
  5. Kim HJ, Lee JW, Jung S, et al. A case of adenomyoma causing jejunal bleeding. Korean J Gastrointest Endosc 2003;27:549-552.
  6. Berk T, Friedman LS, Goldstein SD, Marks GP, Rosato FE. Relapsing acute pancreatitis as the presenting manifestation of an ampullary neoplasm in a patient with familial polyposis coli. Am J Gastroenterol 1985;80:627-629.
  7. Hammarstrom LE, Holmin T, Stenram U. Adenomyoma of the ampulla of Vater: an uncommon cause of bile duct obstruction. Surg Laparosc Endosc 1997;7:388-393. https://doi.org/10.1097/00019509-199710000-00006
  8. Albores-Saavedra JH, Henson DE, Sobin LH, Gibson JB. Histological typing of tumors of the gallbladder and extrahepatic bile duct. Berlin: Springer-Verlag, 1991:348-349.
  9. Lauffer JM, Baer HU, Maurer CA, et al. Adenomyoma of the distal common bile duct mimicking cholangiocarcinoma. Dig Dis Sci 1998;43:1200-1204. https://doi.org/10.1023/A:1018843421292
  10. Lee JS, KIM HS, Jung JJ, Kim YB. Adenomyoma of the small intestine in an adult: a rare cause of intussusception. J Gastroenterol 2002;37:556-559. https://doi.org/10.1007/s005350200086
  11. Park HS, Lee SO, Lee JM, Kang MJ, Lee DG, Chung MJ. Adenomyoma of the small intestine: report of two cases and review of the literature. Pathol Int 2003;53:111-114. https://doi.org/10.1046/j.1440-1827.2003.01435.x
  12. Narita T, Yokoyama M. Adenomyomatous hyperplasia of the papilla of Vater: a sequela of chronic papillitis? Ann Diagno Pathol 1999;3:174-177. https://doi.org/10.1016/S1092-9134(99)80045-8
  13. Kim TH, Park DH, Shim KY, et al. Ampullary adenomyoma presenting as acute recurrent pancreatitis. World J Gastroenterol 2007;13:2892-2894. https://doi.org/10.3748/wjg.v13.i20.2892
  14. Jang KT, Heo JS, Choi SH, et al. Adenomyoma of ampulla of Vater or the common bile duct: a report of three cases. Korean J Pathol 2005;39:59-62.
  15. Kim JW, Jang JY, Han SS, Choi MK, Kim SW, Park YH. Adenomyoma of the Vaterian ampulla. Korean J Hepatobiliary Pancreat Surg 2004;8:258-261.