신경내분비종양은 드물지만 완전 절제가 필요한 종양으로 십이지장 주유두에 발생한 경우 췌십이지장절제술이 권고되어 왔다. 하지만 수술에 따른 위험도를 고려할 때, 분화도가 좋고 전이가 없으며 췌관이나 담관에 침범이 없는 선택된 경우에 한해서 내시경절제술이 시도되고 있다. 이번 증례는 내시경 유두절제술을 통하여 신경내분비종양을 완전히 절제하는데 성공한 증례로 십이지장 주유두 신경내분비종양에 있어서 수술에 대한 위험도가 높을 경우 내시경절제술이 대안이 될 수 있음을 보여주었다.

Tumors of the major duodenal papilla, also known as ampullary tumor, are rare with an approximate 5% incidence of all gastrointestinal neoplasm. These tumors seem to be detected more frequently with increasing performance of upper endoscopic examination and endoscopic retrograde cholangiopancreatography (ERCP). Adenoma, most common benign disease of ampullary tumor, is very important because of its potential to undergo malignant transformation to ampullary cancer. Especially, endoscopic ultrasound or transpapillary intraductal ultrasonography can provide more detailed and accurate information on the extent of ampullary tumors and proper treatment should be done after diagnosis. Considering perioperative morbidity and mortality of surgical resection, endoscopic papillectomy is regarded as a curative treatment of ampullary adenoma. However, the indication of the procedure is very strict and there are various complications related to the procedure. Therefore, it is important to understand the role of endoscopy in diagnosis and treatment of ampullary tumor. In this review, the diagnostic role of endoscopy for ampullary tumor and the treatment method of endoscopic papillectomy will be discussed.