Endoscopic papillectomy of minor papillar adenoma associated with pancreas divisum

Figure 1 Endoscopy showing an 18-mm, whitish, elevated, slightly rough-surfaced mass, located proximal to the major papilla.

Figure 2 Hypotonic duodenography demonstrating a mass situated 15 mm proximal to the major papilla, which was raised highly from the duodenum.

Figure 3 EUS detected an 18 mm × 12 mm homogeneous, hypoechoic mass in the submucosal layer.

Figure 4 ERP was immediately performed via the minor papilla and it showed that the entire dorsal pancreatic ductal system was without communication with the ventral pancreatic duct.

Figure 5 A pancreatic 5Fr stent was placed immediately after endoscopic papillectomy and coagulated the margin of the minor papilla tumor.

Figure 6 Histopathological findings of the specimen showed tubular adenoma and the margin of the tumor was negative; however, a slight infiltration of the pancreatic duct system was revealed (HE stain, × 4).