내시경 절제술로 제거된 소유두의 점막하 종양 2예
Two Cases of Endoscopic Resection of Submucosal Tumor of the Minor Papilla
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십이지장의 소유두에 생기는 종양은 매우 드물고 주로 유암종이나 somatostatinoma와 같은 신경내분비계 종양으로 알려져 왔다. 소유두의 종양은 대부분 점막하종양의 소견을 보이므로 일반적인 조직검사만으로 진단이 어렵기 때문에 주로 수술이나 내시경 절제술에 의해서 진단이 가능하다. 이런 소유두의 종양을 진단하기 위해서는 내시경초음파와 내시경역행성췌담관조영술이 필요하고 유암종과 같은 악성 종양의 가능성이 있으므로 복부 전산단층촬영이나 자기공명영상의 검사가 필요하다. 국내에서는 주유두에 발생한 신경절세포 부신경절종과 이소성 췌장의 보고가 있었지만 아직까지 소유두에 발생한 이소성 췌장이나 신경절세포 부신경절종에 대한 보고는 없었다. 저자들은 우연히 발견된 십이지장 소유두의 점막하종양의 2예에서 진단과 치료를 목적으로 시행한 내시경 절제술에 의해서 제거된 이소성 췌장과 신경절세포 부신경절종을 비슷한 시기에 경험하였기에 문헌 고찰과 함께 보고하는 바이다.
Abstract
Tumors of the minor papilla are very rare and these tumors have generally been known as neuroendocrine tumors such as carcinoid tumor and somatostatinoma. As these are mostly submucosal tumors, their diagnosis is difficult by just performing endoscopic forceps biopsy, but diagnosis is possible by surgery or endoscopic resection. EUS and ERCP is an essential tool for the diagnosis of these tumors, and abdominal CT or MRI is also useful because there is the possibility of malignant tumors such as carcinoid tumor. For our present two cases, screening endoscopy revealed the polypoid lesion of the minor papilla. EUS disclosed that the submucosal tumor was limited to the submucosal layer and no abnormality was found from the abdominal CT and ERCP. Herein, we performed endoscopic resection for making the diagnosis and treatment. Histologically, these 2 tumors were diagnosed as ectopic pancreas and gangliocytic paraganglioma, respectively. (Korean J Gastrointest Endosc 2007;34:164-169)
참고문헌 (19)
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