Synchronous adenocarcinomas of the papilla major and minor

Synchronous malignancies affecting both the major and minor papilla are rare and are usually of endocrine origin.

A 60-year-old female presented with a two-week history of progressive jaundice and pruritus. Evaluation revealed features of a periampullary malignancy. A Whipple pancreaticoduodenectomy was done. There was a growth in the ampulla of Vater and another in the region of the minor duodenal papilla. On histopathology, both lesions were adenocarcinomas.

Although rare, synchronous adenocarcinomas can occur in the major and minor papilla.