Adenomyomatous Hyperplasia of the Vaterian System Peculiar by the Association with a Concomitant Low Grade Pancreatic Intraepithelial Neoplasia - A Rare Case Report

Adenomyomas are rare benign lesions that have been observed in different sites throughout the gastrointestinal tract, most frequently in the gallbladder. Few cases have been described in the stomach, small bowel, bile ducts, and the ampullary region. Adenomyomas of the Vaterian system (ampulla and common bile duct) have important clinical consequences, since most lesions present with biliary tract obstruction and mimic malignancy. As a consequence, considering the diagnostic difficulty of these lesions, patients are often treated with extensive surgery (pancreaticoduodenectomy). We present a rare case of adenomyomatous hyperplasia of the ampulla of Vater peculiar by the association with a concomitant low grade pancreatic intraepithelial neoplasia (Pan - IN).