[Coexistence of an extensive tubulovillous adenoma of the duodenum and a cancer of Vater's ampulla].

In the present paper we report about a patient with a large tubulo-villous duodenal adenoma associated with a carcinoma of the ampulla of Vater. Despite of lacking pre- and intraoperative evidence of malignancy a Whipple operation was performed because of extensive growth of the duodenal adenoma and its location near the ampulla of Vater. The carcinoma of the ampulla could be diagnosed only postoperatively in the resected duodenum. The problems of the presented case and the operative procedure is discussed based on a review of the literature.