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We present a 71-year-old male with obstructive jaundice and imaging concerning for malignancy who was found to have a high-grade ampullary adenoma following attempted pancreaticoduodenectomy. Operative management required modification of the standard approach due to intraoperative anatomical distortions. This case highlights the diagnostic challenges in differentiating benign from malignant ampullary lesions and the implications for surgical management.<\/jats:p>","DOI":"10.1093\/jscr\/rjag925","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:36:37Z","timestamp":1790681797000},"source":"Crossref","is-referenced-by-count":0,"title":["Sporadic ampullary adenoma mimicking adenocarcinoma in the absence of genetic predisposition: a case report"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8985-9432","authenticated-orcid":false,"given":"Anthony A","family":"Poluyanoff","sequence":"first","affiliation":[{"name":"Virginia Tech Carilion School of Medicine , 2 Riverside Circle, Roanoke, VA 24016 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebunoluwa A","family":"Ajadi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Roanoke Memorial Hospital , 1906 Belleview Ave SE, Roanoke, VA 24016 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan","family":"Flood","sequence":"additional","affiliation":[{"name":"Department of Surgery, Roanoke Memorial Hospital , 1906 Belleview Ave SE, Roanoke, VA 24016 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnold D","family":"Salzberg","sequence":"additional","affiliation":[{"name":"Department of Surgery, Roanoke Memorial Hospital , 1906 Belleview Ave SE, Roanoke, VA 24016 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"2026101421580222500_ref1","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1016\/j.gie.2020.01.028","article-title":"American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in familial adenomatous polyposis 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