Adenomyoma of the ampullary region: imaging findings in four patients

Abstract

Background: We report the imaging features of adenomyoma of the distal common bile duct (CBD) and increase awareness of this rare benign disease.

Methods: Four patients (age range = 66-71 years) with abdominal pain and biliary obstruction had spiral computed tomography (CT) and cholangiography with or without papilla biopsy. Two patients also had endoscopic ultrasound.

Results: The CT appearance of adenomyoma was that of a rounded, well-circumscribed, soft tissue mass in the ampullary region, which appeared on cholangiography as a well-defined intraluminal filling defect or caused abrupt and regular stenosis of the CBD. Unfortunately, none of our patients was diagnosed before surgery, and cephalic duodenopancreatectomy was performed in all of them.

Conclusion: Although imaging findings are not specific, their presence should raise the possibility of a benign tumor. If a proper preoperative diagnosis is made, cephalic duodenopancreatectomy can be avoided.