The Korean Journal of Medicine

  • 제86권3호
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  • Pages.319-324
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  • 2014
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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내시경 유두절제술로 제거한 거대 십이지장 주유두의 신경내분비종양

A Large Neuroendocrine Tumor of the Major Duodenal Papilla Removed by Endoscopic Papillectomy

  • 배승현 (울산대학교 의과대학 서울아산병원 내과) ;
  • 김진용 (울산대학교 의과대학 서울아산병원 내과) ;
  • 김창래 (울산대학교 의과대학 서울아산병원 내과) ;
  • 최영권 (울산대학교 의과대학 서울아산병원 내과) ;
  • 신보미 (울산대학교 의과대학 서울아산병원 내과) ;
  • 홍승모 (울산대학교 의과대학 서울아산병원 병리과) ;
  • 김명환 (울산대학교 의과대학 서울아산병원 내과)
  • Bae, Seung-Hyeon (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Jin Yong (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Chang Lae (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Young Kwon (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Shin, Bo Mi (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hong, Seung-Mo (Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Myung-Hwan (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2013.04.17
  • 심사 : 2013.05.09
  • 발행 : 2014.03.01
⟨ 이전 논문 다음 논문 ⟩

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.

키워드

참고문헌

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피인용 문헌

  1. A Case of Ampullary Neuroendocrine Tumor Treated by Endoscopic Papillectomy vol.19, pp.4, 2014, https://doi.org/10.15279/kpba.2014.19.4.204