Ampullary Pyloric Gland Adenoma with High-grade Dysplasia (Video)

AbstractBackgroundAmpullary adenoma can be incidental or syndromic and is generally tubular, villous, or tubulovillous in histology. Pyloric gland adenoma (PGA) is uncommon, especially at extra-gastric locations.Patient & methodsIn this video manuscript, we present a case of 2cm ampullary PGA with high-grade dysplasia (HGD), its endoscopic features, and endoscopic ampullectomy for complete resection.ResultsUnder endoscopy, this ampullary PGA displayed a smooth mucosal surface with minimal pit patterns, unlike those pit patterns observed in tubular and villous adenomas. Pathologically, there was complete excision of PGA with HGD. The MUC6 immunostaining performed was positive, confirming the diagnosis of PGA.ConclusionsEndoscopists and pathologists should be aware of PGA. Endoscopic resection should be performed for complete removal