Chilakala Akhila, Davis Brenton G, Hamerski Christopher M
Kaiser Permanente San Francisco, San Francisco, CA.
ACG Case Rep J. 2025 Jun 5;12(6):e01723. doi: 10.14309/crj.0000000000001723. eCollection 2025 Jun.
Benign neoplasms of the ampulla of Vater are infrequently encountered: overall adenomas account for <10% of ampullary neoplasms; adenomyomas are even rarer. This report describes the case of a 78-year-old woman who presented with epigastric pain, elevated lipase and transaminases with imaging notable for acute pancreatitis, and intrahepatic and common bile duct biliary dilatation without choledocholithiasis. A 25-mm ampullary mass was identified during esophagogastroduodenoscopy with endoscopic ultrasound. The mass was determined to be suitable for endoscopic mucosal resection, which was subsequently performed. Histological examination confirmed a benign submucosal Vaterian adenomyoma with overlying mucosal high-grade glandular adenomatous dysplasia. This presentation is exceptionally rare in clinical practice.
Vater壶腹的良性肿瘤很少见：总体而言，腺瘤占壶腹肿瘤的比例不到10%；腺肌瘤则更为罕见。本报告描述了一名78岁女性的病例，该患者表现为上腹部疼痛、脂肪酶和转氨酶升高，影像学检查显示为急性胰腺炎，肝内和胆总管胆管扩张且无胆总管结石。在食管胃十二指肠镜检查及内镜超声检查中发现一个25毫米的壶腹肿物。该肿物被判定适合进行内镜黏膜切除术，随后进行了该手术。组织学检查证实为良性黏膜下Vater腺肌瘤，伴有黏膜上层高级别腺性腺瘤样发育异常。这种表现在临床实践中极为罕见。
