[Papillary tumors - therapeutic concepts].

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pathology

Background:

• Papillary tumors of the ampulla of Vater are rare and heterogeneous.
• Intestinal-type adenomas and papillary carcinomas are the most common benign and malignant subtypes, respectively.
• Pancreaticobiliary-differentiated carcinomas are associated with a poorer prognosis.

Purpose of the Study:

• To provide a comprehensive overview of papillary tumors of the ampulla of Vater.
• To outline diagnostic and therapeutic strategies for these tumors.
• To emphasize the importance of multidisciplinary management for malignant cases.

Main Methods:

• Diagnosis relies on side-view upper endoscopy with biopsy.
• Malignancy staging involves computed tomography (CT) and endoscopic ultrasound.
• Treatment strategies include endoscopic snare papillectomy for adenomas and pancreatic head resection for carcinomas.

Main Results:

• Intestinal differentiated adenomas are the most common benign lesions.
• Intestinal differentiated papillary carcinomas are the most common malignant tumors.
• Adjuvant therapy may benefit patients with papillary carcinomas, guided by histological differentiation.

Conclusions:

• Papillary tumors of the ampulla of Vater require accurate diagnosis and tailored treatment.
• Endoscopic papillectomy is suitable for benign lesions.
• Surgical resection and adjuvant therapy are crucial for malignant papillary carcinomas, necessitating interdisciplinary decision-making.