[Papilla carcinoma and adenoma--diagnosis and therapy]

26 peripapillary adenomas and 64 papillary carcinomas are the background for a discussion of the adenoma-carcinoma-sequence in these tumours. An early diagnosis of the adenomas means in this context secondary prophylaxis of papillary carcinomas. Nowadays, the greatest difficulties consist in the differentiation of adenomyomatosis-like processes of the papilla and in the certainty that an adenoma has not changed to a carcinoma. In patients who cannot tolerate a greater surgical procedure the endoscopic papillotomy, possibly in combination with a prosthesis, is an appropriate measure.