Adenocarcinoma of Ampulla of Vater Presented as Recurrent Jaundice
AbstractBackground Ampullary carcinoma are relatively uncommon neoplasm which approximately seen in 0.2% of gastrointestinal carcinomas. Clinically these patient generally present at an earlier stage of the disease. As their strategic location may cause early biliary obstruction. Case history A 70 year old male patient was presented with history of pain in abdomen, anorexia and repeated history of jaundice. On ultrasonography and CT scan abdomen-pelvis showed proliferative growth at periampullary area suggestive of ampullary malignancy. Associated cholelithiasis was noted. Patient underwent surgical treatment of pancreaticoduodenectomy with cholecystectomy. On histopathology revealed moderately differentiated intestinal type of adenocarcinoma of ampulla of Vater, Grade II. Conclusion We are presenting this uncommon neoplasm for its rarity, recently distinguished subtype on histopathology, clinical behavior and radiological findings.
Benhamiche AM, Jouve JL, Manfredi S, Prost P, Isambert N, Faivre J .Cancer of the ampulla of Vater: results of a 20-year population-based study, Eur J Gastroenterol Hepatol. 2000 Jan;12(1):75-9.
Kim RD, Kundhal PS, McGilvray ID, Cattral MS, Taylor B, Langer B, Grant DR, Zogopoulos G, Shah SA, Greig PD, et al. Predictors of failure after pancreaticoduodenectomy for ampullary carcinoma. J Am Coll Surg. 2006;202:112–119.
Zhou H, Schaefer N, Wolff M, et al. Carcinoma of the ampulla of Vater : comparative histologic/immunohistochemical classification and follow-up. Am J Surg Pathol 2004;28:875-882.
Kimura W, Futakawa N, Zhao B. Neoplastic diseases of the ampulla of Vater. J Hepatobiliary Pancreat Surg 2004;11:223-231.
Costi R, Carvana P, Sarli I, et al. Ampullary adenocarcinoma in neurofibromatosis type I. Case report and literature review. Mod Pathol 2001;14:1169-74.
Wagner PI, Chen YT, Yantiss RK. Immunohistochemical and molecular features of sporadic and FAP-associated duodenal adenomas of ampullary and nonampullary mucosa. Am J Surg Pathol 2008;32:1338-1395.
Gardiner GW, Lojrie G, Keith R. Hepatoid adenocarcinoma of the papilla of Vater. Histopathology 1992;20:541-544.
Carter JT, Grenert JP, Rubenstein L. Tumors of the ampulla of Vater, histological classification and predictor of survival. J Am Coll Surg 2008,207(2):210-8.
Berberat PO, Kunzli BM, Gulbinas A, et al. An audit of outcomes of a series of periampullary carcinoma. Eur J Surg Oncol 2009;35:187-91.
Howe JR, Klimstra DS, Moccia RD, et al. Factors predictive of survival in ampullary carcinoma. Ann Surg 1998;228:87-94.
Kim WS, Choi DW, Choi SH, et al. Clinical significance of pathologic subtype in curatively resected ampulla of Vater. J Surg Oncol 2012;105(3):266-72.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).