Malignant transformation of anomalous opening of the common bile duct in the pylorus as well as in the duodenal bulb: report of two cases

Appearance of anomalous bile duct opening, especially the presence of the papilla Vateri in the duodenal bulb and in the pylorus is extremely rare. There are only a few reports mentioned in the literature, where similar cases had been described. We could have found no information about malignant transformation of a such located papilla Vateri at all. For the time being the possibility of a tumour was assumed in three cases, but in none of them its evidence had been proved by surgical samples or histological processing.

In our cases we found two tumours of the atypically located papilla Vateri in the pylorus and in the duodenal bulb where the malignancy could have been proved by endoscopic, histological and surgical evaluating methods.

This presentation is about a 74 and a 78 years old patient suffering from obstructive jaundice due to the adenocarcinoma of an atypically located papilla Vateri in the pylorus and in the duodenal bulb. Our videos will illustrate the special situations. In both cases our assumption had been proved by a biopsy. One of the patients had refused the surgical treatment, so that we decided to provide the free flow of bile with endoscopic intervention.

We will demonstrate the atypical circumstances, which made the canulation of the bile duct difficult during the treatment.

We proved early cancer in the case of the second patient had been set to Whipple operation. In our presentation we are going to elaborate the literary data and show you videos, MRCP and biopsy reports from our two patients.