Endoscopic Papillectomy for Ampullary Adenoma Adjacent to a Cystic Lesion

Koji Takahashi; Kenjiro Yamamoto; Takanori Aihara; Izumi Ohno; Hiroshi Ohyama

doi:10.7759/cureus.81318

Endoscopic Papillectomy for Ampullary Adenoma Adjacent to a Cystic Lesion

Cureus. 2025 Mar 27;17(3):e81318. doi: 10.7759/cureus.81318. eCollection 2025 Mar.

Authors

Koji Takahashi^{1

2}, Kenjiro Yamamoto³, Takanori Aihara⁴, Izumi Ohno^{1

2}, Hiroshi Ohyama¹

Affiliations

¹ Gastroenterology, Chiba University, Chiba, JPN.
² Medical Oncology, Chiba University, Chiba, JPN.
³ Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, JPN.
⁴ Pathology, Chiba University, Chiba, JPN.

Abstract

Ampullary adenomas are precancerous lesions with a high risk of malignant transformation. Endoscopic papillectomy is the standard treatment, but the presence of adjacent cystic lesions poses a technical challenge. An 83-year-old man underwent an endoscopic examination, which revealed an ampullary tumor adjacent to a cystic lesion. Endoscopic ultrasound and MRI confirmed its cystic nature. A biopsy diagnosed an intestinal-type adenoma. The patient underwent en bloc endoscopic papillectomy with simultaneous resection of the cystic lesion. The procedure was complication free, and histopathological analysis confirmed a nonmalignant adenoma with negative resection margins. The cystic lesion was identified as a dilated glandular duct without adenomatous components. This case underscores the importance of detailed imaging for preoperative planning. En bloc endoscopic papillectomy is a feasible and safe approach for ampullary adenomas with adjacent cystic lesions. A thorough preoperative assessment and meticulous procedural planning are crucial for achieving complete resection with negative margins.

Keywords: ampulla of the vater; ampullary adenoma; cysts; duodenal adenoma; endoscopy.

Publication types

Case Reports