Undifferentiated carcinoma of the duodenal ampulla

Sato, Takafumi; Yamamoto, Kyoji; Ouchi, Akihiko; Imaoka, Youichi; Takeuchi, Hiromi; Matsushiro, Takashi

doi:10.1007/bf02347570

Cited by 9 publications

(7 citation statements)

References 11 publications

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“…Although undifferentiated carcinoma is characterized by the absence of glands, the presence of small round atypical cells without ductal differentiation in the majority of the tumor led us to believe that the diagnosis in this case was undifferentiated carcinoma. To the best of our knowledge, there has been only one case report on undifferentiated carcinoma of an ampullary lesion till date in which small cells grew similar to those observed in the present patient [4]. …”

Section: Discussionsupporting

confidence: 62%

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Undifferentiated carcinoma of the ampulla of Vater

et al. 2017

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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 the ampulla of Vater is a very rare histological type. More number of cases is necessary to clarify optimal treatment.

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Section: Discussionsupporting

confidence: 62%

“…In fact, undifferentiated carcinoma is reported to account for 3–7% of gallbladder cancer [1, 2], but only a few cases of extrahepatic bile duct and papillary cancer [3, 4] have been reported. We report the case of a patient with undifferentiated carcinoma that developed in the ampulla of Vater.…”

Section: Introductionmentioning

confidence: 99%

Undifferentiated carcinoma of the ampulla of Vater

et al. 2017

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“…Although we found many case reports of undifferentiated carcinoma with osteoclast-like giant cells of the pancreatic head with direct invasion to the periampullary lesion, none described a tumor located mainly in the periampullary region. 4,8 In our patient, the main pancreatic duct and common bile duct were histologically free of invading cancer cells and the mass was located mainly in the periampullary region, protruding into the duodenum. On the basis of these anatomical and topographical features, we diagnosed a tumor of the periampullary region.…”

Section: Discussionmentioning

confidence: 96%

“…The histological appearance resembles that of similar tumors of the gallbladder, bile ducts, or pancreas. 1,4 Carcinoma with osteoclast-like giant cells are seen in a variety of benign and malignant mesenchymal tumors, and in recurrences and metastatic deposits. 1,7,8 There may be gross evidence of invasion into adjacent organs.…”

Section: Discussionmentioning

confidence: 99%

“…The histological appearance of osteoclast-like giant cells involving the periampulla resembles that of similar tumors of the gallbladder, bile ducts, or pancreas. 4,5 Since there are few case reports of undifferentiated carcinomas with osteoclast-like giant cells in the periampullary region, the clinical features and therapeutic strategies are not well understood. 6 We report a case of periampullary carcinoma, histologically composed of undifferentiated cells and evenly spaced osteoclast-like giant cells, which we treated successfully with surgery followed by chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Surgically resected undifferentiated carcinoma with osteoclast-like giant cells of the periampullary region involving the orifice of the papilla of vater: Report of a case

et al. 2010

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Undifferentiated carcinomas with osteoclast-like giant cells are rare periampullary neoplasms, which morphologically mimic giant cell tumors of the bone. The terminology, histogenesis, biological behavior, and chemosensitivity of these tumors, and their treatment protocol, remain controversial. We report the case of a 71-year-old man with periampullary carcinoma who underwent pancreaticoduodenectomy under the diagnosis of periampullary carcinoma. Histologically, the neoplasm was composed of undifferentiated cells and evenly spaced osteoclast-like giant cells. Liver and paraaortic lymph node metastases were detected 6 months later and were treated effectively with intravenous gemcitabine. The patient remains in remission 2 years after surgery.

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MDCT and MRI of the ampulla of Vater (part I): technique optimization, normal anatomy, and epithelial neoplasms

et al. 2015

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The purpose of this two-part article is to review the cross-sectional anatomy of the ampulla and periampullary region, to propose novel and optimized MDCT and MRI techniques that allow accurate evaluation of the ampulla of Vater, and to summarize the cross-sectional imaging features of benign and malignant ampullary conditions. In this first part, we will review the normal anatomy of the ampullary region, provide suggestions on how to optimize evaluation of the ampullary region by MDCT and MRI, and review the imaging features of select epithelial neoplasms of the ampulla. Familiarity with the normal ampullary anatomy and the pathologic conditions involving the ampulla, as well as the use of optimized MDCT and MRI techniques, may improve the diagnostic accuracy of radiologists facing ampullary abnormalities.

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Undifferentiated carcinoma of the duodenal ampulla

Cited by 9 publications

References 11 publications

Undifferentiated carcinoma of the ampulla of Vater

Undifferentiated carcinoma of the ampulla of Vater

Surgically resected undifferentiated carcinoma with osteoclast-like giant cells of the periampullary region involving the orifice of the papilla of vater: Report of a case

MDCT and MRI of the ampulla of Vater (part I): technique optimization, normal anatomy, and epithelial neoplasms

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