Benign villous adenomas of the ampulla of Vater.

One of the most unusual sites of isolated villous adenomas is the ampulla of Vater. Six patients with this neoplasm have recently been identified. The mean age was 68 years, and four were female. Four of the six were evaluated on several occasions before definitive diagnosis. Preoperative endoscopy correctly identified the lesions in two of three patients. Five patients underwent local resection and one a radical pancreaticoduodenectomy. Six benign neoplasms of the ampulla were found. In discussing this entity, of which there have been 38 reported cases in the literature, the role of local excision that can be combined with more complex procedures such as sphincteroplasty and duct implantation should be emphasized.