Undifferentiated carcinoma of the ampulla of Vater

Surgical Case Reports
Misuzu YamadaToshio Nakagohri

Abstract

Undifferentiated carcinoma of the ampulla of Vater is a rare disease with unclear and clinical characteristics and prognosis. Here, we report the case of a 61-year-old man with undifferentiated carcinoma of the ampulla of Vater. He presented to our hospital with an increase in hepatobiliary system enzymes that was detected during a health check-up. Imaging and endoscopy demonstrated a tumor with ulcer in the ampulla of Vater, which was diagnosed as a carcinoma by biopsy. No distant metastasis was observed. Subtotal stomach-preserving pancreaticoduodenectomy was performed. Undifferentiated carcinoma was confirmed based on the presence of small round atypical cells with the formation of a solid alveolar lesion on histopathological examination and immunohistochemical staining that was positive for CAM 5.2 but negative for chromogranin A and synaptophysin. The tumor infiltrated the duodenum, but not the pancreas; no lymph node metastasis was observed. However, liver metastases were detected 2 months postoperatively. Chemotherapy was performed, and the tumor size temporality decreased; however, it grew in size again, and the patients subsequently died of the primary disease 15 months postoperatively. Undifferentiated carcinoma of th...Continue Reading

References

Aug 1, 1995·Journal of Gastroenterology·T SatoT Matsushiro
Oct 21, 2006·Annals of Surgical Oncology·Hui-Ping HsuPin-Wen Lin
Feb 28, 2007·Journal of Surgical Oncology·Joon Seong ParkByong Ro Kim
Jan 8, 2008·The Lancet Oncology·Irvin R ModlinAnders Sundin
Apr 9, 2010·The New England Journal of Medicine·Juan ValleABC-02 Trial Investigators
Jun 27, 2013·Journal of Hepato-biliary-pancreatic Sciences·Hyo Jun ParkSeong Ho Choi
Dec 25, 2015·Journal of Hepato-biliary-pancreatic Sciences·Shin IshiharaTadahiro Takada

Methods Mentioned

BETA
biopsy

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