Villous tumors of the duodenum

Two patients with villous adenomas in the duodenum are described. These lesions have a predilection for the ampullary region, and tend to present with obstructive jaundice, especially if malignancy is present. The first patient, with a villous adenoma located at the ampulla of Vater, presented with jaundice and underwent pancreaticoduodenectomy at a second operation because of a high rate of false-negative biopsies. The second patient was admitted with partial mechanical obstruction symptoms and was treated by partial duodenectomy and antrectomy for a supraampullary villous adenoma, including in situ carcinoma.