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Adenoma—Carcinoma Sequence in the Papilla of Vater

Adenoma—Carcinoma Sequence in the Papilla of Vater Background: Our aims were to investigate the question as to whether the adenoma–carcinoma sequence also applies to the papilla of Vater and to determine the frequency with which a tumour of the papilla of Vater, diagnosed histologically as containing portions of an adenoma, already contains adenocarcinoma elsewhere. Methods: A retrospective analysis was carried out of the forceps, snare biopsy, and excised specimens obtained from the papilla of Vater in 559 patients, including 210 patients with the primary diagnosis of carcinoma and 110 patients with the diagnosis of ‘portions of an adenoma’. Comparisons were made of the age distribution of patients with adenoma and those with carcinoma, and the frequency of residual adenoma in a carcinoma as a function of degree of malignancy, T stage, and UICC stage. A follow-up examination of the patients with the primary diagnosis ‘parts of an adenoma of the papilla of Vater’ was performed. Results: The average age of the patients with the final diagnosis adenoma was 65.2 years, and that of the carcinoma patients 73.0 years. Residual adenoma was found in 54.9% of the 51 surgical specimens and in 31.7% of the 159 biopsy specimens obtained from carcinomas. The frequency of residual adenoma in carcinomas decreased statistically significantly with increasing T stage and degree of malignancy. The follow-up examination of the 110 patients with the primary biopsy diagnosis parts of an adenoma of the papilla of Vater showed unequivocal results in 80 cases. Only in 39.7% of these cases was the primary diagnosis adenoma confirmed, whereas in 60.25%, further histologic examination showed a carcinoma. Conclusions: An analysis of our results, together with those reported in the literature, indicates that the adenoma–carcinoma sequence also applies to the papilla of Vater and that, in a high percentage of patients with the histologic diagnosis ‘parts of an adenoma’, other regions of the tumour already contain a carcinoma. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Scandinavian Journal of Gastroenterology Taylor & Francis

Adenoma—Carcinoma Sequence in the Papilla of Vater

Adenoma—Carcinoma Sequence in the Papilla of Vater

Scandinavian Journal of Gastroenterology , Volume 31 (4): 7 – Jan 1, 1996

Abstract

Background: Our aims were to investigate the question as to whether the adenoma–carcinoma sequence also applies to the papilla of Vater and to determine the frequency with which a tumour of the papilla of Vater, diagnosed histologically as containing portions of an adenoma, already contains adenocarcinoma elsewhere. Methods: A retrospective analysis was carried out of the forceps, snare biopsy, and excised specimens obtained from the papilla of Vater in 559 patients, including 210 patients with the primary diagnosis of carcinoma and 110 patients with the diagnosis of ‘portions of an adenoma’. Comparisons were made of the age distribution of patients with adenoma and those with carcinoma, and the frequency of residual adenoma in a carcinoma as a function of degree of malignancy, T stage, and UICC stage. A follow-up examination of the patients with the primary diagnosis ‘parts of an adenoma of the papilla of Vater’ was performed. Results: The average age of the patients with the final diagnosis adenoma was 65.2 years, and that of the carcinoma patients 73.0 years. Residual adenoma was found in 54.9% of the 51 surgical specimens and in 31.7% of the 159 biopsy specimens obtained from carcinomas. The frequency of residual adenoma in carcinomas decreased statistically significantly with increasing T stage and degree of malignancy. The follow-up examination of the 110 patients with the primary biopsy diagnosis parts of an adenoma of the papilla of Vater showed unequivocal results in 80 cases. Only in 39.7% of these cases was the primary diagnosis adenoma confirmed, whereas in 60.25%, further histologic examination showed a carcinoma. Conclusions: An analysis of our results, together with those reported in the literature, indicates that the adenoma–carcinoma sequence also applies to the papilla of Vater and that, in a high percentage of patients with the histologic diagnosis ‘parts of an adenoma’, other regions of the tumour already contain a carcinoma.

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References (34)

Publisher
Taylor & Francis
Copyright
© 1996 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted
ISSN
1502-7708
eISSN
0036-5521
DOI
10.3109/00365529609006414
Publisher site
See Article on Publisher Site

Abstract

Background: Our aims were to investigate the question as to whether the adenoma–carcinoma sequence also applies to the papilla of Vater and to determine the frequency with which a tumour of the papilla of Vater, diagnosed histologically as containing portions of an adenoma, already contains adenocarcinoma elsewhere. Methods: A retrospective analysis was carried out of the forceps, snare biopsy, and excised specimens obtained from the papilla of Vater in 559 patients, including 210 patients with the primary diagnosis of carcinoma and 110 patients with the diagnosis of ‘portions of an adenoma’. Comparisons were made of the age distribution of patients with adenoma and those with carcinoma, and the frequency of residual adenoma in a carcinoma as a function of degree of malignancy, T stage, and UICC stage. A follow-up examination of the patients with the primary diagnosis ‘parts of an adenoma of the papilla of Vater’ was performed. Results: The average age of the patients with the final diagnosis adenoma was 65.2 years, and that of the carcinoma patients 73.0 years. Residual adenoma was found in 54.9% of the 51 surgical specimens and in 31.7% of the 159 biopsy specimens obtained from carcinomas. The frequency of residual adenoma in carcinomas decreased statistically significantly with increasing T stage and degree of malignancy. The follow-up examination of the 110 patients with the primary biopsy diagnosis parts of an adenoma of the papilla of Vater showed unequivocal results in 80 cases. Only in 39.7% of these cases was the primary diagnosis adenoma confirmed, whereas in 60.25%, further histologic examination showed a carcinoma. Conclusions: An analysis of our results, together with those reported in the literature, indicates that the adenoma–carcinoma sequence also applies to the papilla of Vater and that, in a high percentage of patients with the histologic diagnosis ‘parts of an adenoma’, other regions of the tumour already contain a carcinoma.

Journal

Scandinavian Journal of GastroenterologyTaylor & Francis

Published: Jan 1, 1996

Keywords: Adenoma–carcinoma sequence; papilla of Vater

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