Neuroendocrine Tumors of the Ampulla of Vater

Carter, Jonathan T.

doi:10.1001/archsurg.2009.80

Cited by 47 publications

(33 citation statements)

References 15 publications

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“…Third, all the included NAD-NETs in our present study were ≤20 mm in diameter. Most of the previous studies on D-NETs included those of >20 mm in diameter or ampullary D-NETs [8,10,11,12,14,16,17,18,19], the latter having a growth pattern different from that of NAD-NET [7,8,9,10]. For example, Burke et al [10] reported the pathological finding of 99 D-NETs but 42 of them were >20 mm in diameter and included ampullary tumors.…”

Section: Discussionmentioning

confidence: 99%

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The Risk Factors for Metastasis in Non-Ampullary Duodenal Neuroendocrine Tumors Measuring 20 mm or Less in Diameter

et al. 2017

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Background/Aims: The treatment strategy for non-ampullary duodenal neuroendocrine tumors (NAD-NETs) ≤20 mm in diameter has not been established. In this study, we aimed to evaluate the detailed characteristics of NAD-NETs ≤20 mm in diameter to clarify the risk factors of subsequent metastasis. Methods: The patients with NAD-NETs ≤20 mm in diameter who had been treated at 12 institutions between 1992 and 2013 were enrolled. Clinical records were retrieved, and histopathological findings of all cases were centrally reviewed by 2 pathologists. Results: We studied 49 patients with a mean follow-up period of 66.5 months. Thirty-five patients were initially treated with endoscopic resection (ER), and 14 with surgery. A univariate analysis revealed the ORs and 95% CIs of the risk factors for metastasis were lymphovascular invasion (12.5 [2.01-77.9]), multiple tumors (9.75 [1.46-65.4]), a tumor size of 11-20 mm (6.67 [1.21-36.6]), and World Health Organization grade G2 (7.13 [1.16-43.9]). Five-year overall and disease-specific survival rates were 86.1 and 97.2%, respectively. Conclusion: This is the first study to demonstrate the risk factors of metastasis in NAD-NETs ≤20 mm in diameter. These findings may be helpful for determining the appropriate therapeutic approach and the clinical strategy of treatment following ER.

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Section: Discussionmentioning

confidence: 99%

“…Surgical resection is generally recommended for ampullary D-NET regardless of the tumor size due to its anatomical location and more aggressive behavior compared to the latter type [7,8,9,10]. On the other hand, the therapeutic approach in NAD-NET depends on the size of the tumor.…”

Section: Introductionmentioning

confidence: 99%

The Risk Factors for Metastasis in Non-Ampullary Duodenal Neuroendocrine Tumors Measuring 20 mm or Less in Diameter

et al. 2017

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“…To date, only approximately 120 NETAoVs have been described in the literature, most in less 10 cases reports [1–5]. The incidence and prevalence of neuroendocrine tumor seems to have increased in recent years, most likely due to diagnostic technical improvements and endoscopic healthcare surveillance [6].…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological features and surgical outcomes of neuroendocrine tumors of ampulla of Vater

Yang¹,

Yun²,

Kim³

et al. 2017

BMC Gastroenterol

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BackgroundThe study aims to investigate the clinicopathological features and surgical outcomes of neuroendocrine tumors of ampulla of Vater (NETAoVs) patients who underwent pancreaticoduodenectomy.MethodsFrom January 2007 to December 2014, 45 patients underwent pancreaticoduodenectomy for malignant disease of the ampulla of Vater in our institution. Of those, 5 patients were diagnosed as neuroendocrine tumors. The data included age, sex, presenting symptoms, preoperative imaging, preoperative type of biopsy results, type of operation, pathologic findings and survival status.ResultsThe patient’s mean age was 55.2 ± 9.7 years. Endoscopic ultrasound guided biopsy was performed in 4 patients and gastroduodenoscopic biopsy was performed in one patient. All showed neuroendocrine tumor without mitosis. Mean tumor size was 1.9 ± 0.56 cm (range, 1.2–2.0 cm). Lymph node metastases were detected in two patients. All patients were synaptophysin-positive. Median periods of follow-up were 45 months (range, 43–78 months). Recurrence after operation occurred in two patients. 4 patients were alive at the last follow-up.ConclusionsRadical resection for NETAoVs can provide the information of status of lymph node metastasis after surgery. However, correlation between lymph node metastasis and overall survival is uncertain to date.

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“…Less frequently, gastrointestinal bleeding or pancreatitis (6%) may be present. Weight loss has been seen in 4% -10% of patients at the time of presentation [5] [9]. ANET have been found to occur with higher frequency in patients with neurofibromatosis type 1 and multiple endocrine neoplasia type 1 syndrome, along with other rare cancers such as gastrointestinal stromal cell tumors and periampullary carcinomas.…”

Section: Presenting Symptoms and Diagnosismentioning

confidence: 99%

“…Since tumor size has not been clearly established to correlate with lymph nodal positivity status, pancreaticoduodenectomy is often recommended as the treatment of choice for tumors of any size with no distant spread [9] [12] [13]. However, less invasive procedures like local excision and endoscopic resections have also been successfully attempted, especially for ANET less than 2 cm size or in high risk surgical candidates [4] [5] [14].…”

Section: Therapeutic Optionsmentioning

confidence: 99%

Ampullary Neuroendocrine Tumor: A Rare Cause of Recurrent Abdominal Pain

Ofosu¹,

Taccone²,

Potakamuri³

2014

CRCM

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Ampullary Neuroendocrine tumor (ANET) is a rare GI malignancy, representing less than 1% of GI neuroendocrine tumors and less than 2% of ampullary tumors. Traditional treatment is often a pancreaticoduodenectomy; however, local and endoscopic resections have been successful. We report a rare case of ANET in a 21-year-old Burmese man who presented with a 6-year history of non-specific intermittent abdominal pain who was successfully managed through transduodenal ampullectomy. At 24 months postoperatively he remains disease and symptom free. ANET is a rare cause of recurrent abdominal pain, and local excision of small ANETs can be an alternative, less morbid treatment for young patients. We follow the case with a brief review of the literature.

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Neuroendocrine Tumors of the Ampulla of Vater

Cited by 47 publications

References 15 publications

The Risk Factors for Metastasis in Non-Ampullary Duodenal Neuroendocrine Tumors Measuring 20 mm or Less in Diameter

The Risk Factors for Metastasis in Non-Ampullary Duodenal Neuroendocrine Tumors Measuring 20 mm or Less in Diameter

Clinicopathological features and surgical outcomes of neuroendocrine tumors of ampulla of Vater

Ampullary Neuroendocrine Tumor: A Rare Cause of Recurrent Abdominal Pain

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