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Accession number;03A0117078
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| Title;A Case of Carcinoma of the Papilla of Vater after a Papillectomy for Adenoma of the Ampulla of Duodenum. |
| Author;
HIRAHARA NORIYUKI
(Tsuwanokyozonbyoin Geka)
WATANABE HIROAKI
(Tsuwanokyozonbyoin Geka)
NISHI TAKESHI
(Tsuwanokyozonbyoin Geka)
NIO YOSHINORI
(Shimane Med. Univ., Igakubu)
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Journal Title;Journal of Japan Surgical Association
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Journal Code:Z0103A
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ISSN:1345-2843
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VOL.64;NO.1;PAGE.98-101(2003)
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| Figure&Table&Reference;FIG.4, REF.17 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;A 75-year-old man was admitted to the hospital because of appetite loss. Although slight liver dysfunction was noted at the time of hospitalization, the tumor markers (CEA, CA 19-9) were in normal ranges. Upper gastrointestinal endoscopy visualized an approximately 1cm coarse nodular bulge in the papilla of Vater, which was diagnosed as adenoma by a biopsy. Total papillectomy and a shincteroplasty were performed. Histopathological diagnosis of the resected specimen was adenoma with borderline lesion. However, the patient was found to have a tumor in the papilla of Vater by an endoscopy, which was diagnosed as well differntiated adenocarcinoma by a biopsy 2.5 years after the surgery. It wat judged from the patient's general condition to perform an endoscopic excision. We have not reach a consensus on the biological malignancy of adenoma of papilla of Vater, and so there are no established standard therapies as yet. We consider that total papillectomy should be the first choice of therapy for this disease, if the tumor can be completely removed without any residual tumor, and sufficient examinations for medical treatment are required. (author abst.) |
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