AMPULLECTOMY OF A TRADITIONAL SERRATED ADENOMA

Female, 51 yo. Background: Primary mediastinal lymphoma in CR after radiochemotherapy (2019).

During dyspepsia investigation a big (over 3-cm) sessile (Paris 0-Is) duodenal ampullary lesion was found by upper endoscopy. Regular margins, absence of spontaneous bleeding, both suggesting benignity. Biopsies: papillary tubulovillous adenoma with low-grade dysplasia. EUS: mucosal layer lesion, intermediate echogenicity, no intraductal biliary or pancreatic growing and absence of lymphadenopaties. A snare ampullectomy was performed, followed by sphyncterotomy, double stenting. and argon-ablation of the margins; discharged in 48 hours. Pathology: traditional serrated adenoma with high-grade dysplasia foci and no invasion of lamina propria or submucosa. No 6-month recurrence.

Publication History

Article published online:
14 April 2022