十二指腸絨毛状腺腫の1例

Villous Adenoma of the Duodenum, Report of a Case

　絨毛状腺腫は大腸によくみられる腫瘍であるが，そのほかの消化管ではまれである．今回，われわれは十二指腸に発生した絨毛状腺腫の1例を報告すると共に，併せて文献的考察を行ってみたい．

　A 51 year-old woman with chief complaint of anemia was found to have child's fist sized tumor at the second portion of the duodenum by UGI series and endoscopic examination. We only performed enucleation of the tumor because not only preoperative endoscopic biopsy but also intra-operative frozen section of the tumor disclosed benign villotubular adenoma. The tumor was measured as 6.7×5.0×3.7 cm and had broad base with various sized nodular, protruded and friable surface. Furthermore, each surface of the protruded lesions was either smooth or villous. However, the villous pattern was more dominant, therefore it was diagnosed as villous adenoma.

　In Western countries, more than 60 cases of villous adenoma of the duodenum had been reported so far, but almost all of them was villotubular adenoma which was quite similar to our country.

　On the other hand, malignant transformation of the villous adenoma was found to be 27％ in Western countries and it was much higher incidence than our country. The reason why our country has less incidence of their malignant transformation could be explained by the following fact; namely, the majority of them were reported as early duodenal carcinoma or protruded type of duodenal carcinoma in our country.