Kutin N D, Ranson J H, Gouge T H, Localio S A
Ann Surg. 1975 Feb;181(2):164-8. doi: 10.1097/00000658-197502000-00007.
Villous tumors of the duodenum are rare, but treatment may be problematic because of their association with invasive adenocarcinoma. Two cases of villous tumor of the duodenum are described and 39 other reported cases are reviewed. Presenting symptoms were bleeding 27%; obstruction 24%; jaundice 22% and vague dyspepsia 20%. Diagnosis may be made by radiographic barium contrast evaluation of the duodenum, especially with the addition of air contrast hypotonic studies and by fibro-optic endoscopy. Twenty-seven per cent of villous tumors of the duodenum are associated with adenocarcinoma. Invasive tumor is more common in patients over 50 years old (35%), in tumors of the third and fourth portions of the duodenum (44%) and in tumors over 4 cm in diameter (30%). Local excision is the treatment of choice for benign lesions. Pancreatico-duodenectomy is recommended for tumors which include invasive carcinoma in patients without distal metastases.
十二指肠绒毛状肿瘤较为罕见，但因其与浸润性腺癌相关，治疗可能存在问题。本文描述了2例十二指肠绒毛状肿瘤，并对其他39例报告病例进行了回顾。主要症状包括出血（27%）、梗阻（24%）、黄疸（22%）和模糊不清的消化不良（20%）。十二指肠的放射学钡剂造影评估，尤其是加用空气造影低张造影检查及纤维光学内镜检查，有助于做出诊断。27%的十二指肠绒毛状肿瘤与腺癌相关。浸润性肿瘤在50岁以上患者中更为常见（35%），在十二指肠第三和第四部分的肿瘤中（44%）以及直径超过4 cm的肿瘤中（30%）更为常见。局部切除是良性病变的首选治疗方法。对于无远处转移且肿瘤包含浸润性癌的患者，建议行胰十二指肠切除术。
