Diagnosis of duodenal papillary neoplasms involves endoscopic examination and biopsy, as well as EUS, IDUS, CT, and MRI (MRCP). For treatment, endoscopic papillotomy (EP) or transduodenal papillotomy (TDP) as a reduction procedure are performed for papillary adenomas. For papillary carcinoma, pancreaticoduodenectomy is performed. However, new treatments are being attempted, such as local resection for lesions confined to the mucosa (T1a(M)), which are considered to have a low risk of lymph node metastasis; EP with hybrid ESD for lesions with extensive lateral spread; and endoscopic RFA for adenomas with intraductal invasion. In this symposium, we invite reports on the diagnosis and management of papillary tumors at each institution to share the current status and discuss issues requiring resolution.