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Case Report
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Korean J Med. 2014;86(3):319-324. Published online March 1, 2014.
DOI: https://doi.org/10.3904/kjm.2014.86.3.319
- 내시경 유두절제술로 제거한 거대 십이지장 주유두의 신경내분비종양
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배승현1, 김진용1, 김창래1, 최영권1, 신보미1, 홍승모2, 김명환1
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1울산대학교 의과대학 서울아산병원 내과
2울산대학교 의과대학 서울아산병원 병리과
- A Large Neuroendocrine Tumor of the Major Duodenal Papilla Removed by Endoscopic Papillectomy
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Seung-Hyeon Bae1, Jin Yong Kim1, Chang Lae Kim1, Young Kwon Choi1, Bo Mi Shin1, Seung-Mo Hong2, Myung-Hwan Kim1
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1Departments of 1Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Departments of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Corresponding author: Myung-Hwan Kim ,Tel: +82-2-3010-3183, Fax: +82-2-3010-0824, Email: mhkim@amc.seoul.kr
- Received: April 17, 2013; Revised: April 23, 2013 Accepted: May 9, 2013.
- 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 cm크기의 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.
߽ɾ :신경내분비종양; 십이지장 주유두
- Abstract
- 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. (Korean J Med 2014;86:319-324)
Keywords :Neuroendocrine tumors, Major duodenal papilla
