초록
십이지장 주유두의 신경내분비종양은 드문 종양이지만 크기에 관계없이 세포 분화도가 나쁜 경우 다른 장기에 전이를 일으킬 수 있어 치료 방법으로 췌-십이지장 절제술이 권유되고 있다. 이번 증례는 십이지장 주유두에 발생한 3 cm 크기의 신경내분비종양을 수술 대신 덜 침습적인 내시경 유두절제술을 시행하여 종양을 완전히 절제할 수 있었다. 주유두 신경내분비종양에 있어서 수술에 대한 위험도가 높거나 환자가 수술을 원치 않는 경우에 내시경 유두절제술이 대안이 될 수 있겠다.
Neuroendocrine tumors (NET) of the major duodenal papilla are rare and the natural history of this disease is not clear. We experienced a case in a 31-year-old male. Duodenoscopy revealed an enlarged major duodenal papilla with central umbilication and nodularity. Endoscopic ultrasonography (EUS) demonstrated a 3-cm hypoechoic mass that was confined to the submucosa. A biopsy led to the diagnosis of a grade 1 NET. The patient refused surgery, so we performed an endoscopic papillectomy. The tumor was removed completely. The resected specimen confirmed the diagnosis of a well-differentiated NET and all resection margins were negative. Surgical resection is currently considered to be the gold standard for the treatment of a large NET of the major duodenal papilla; however, endoscopic resection is a possible treatment modality for patients at high surgical risk or who are reluctant to undergo surgery.