title: An investigation of primary malignancies associated with ampullary carcinoma.
abstract: OBJECTIVE
  As ampullary carcinoma has a favorable prognosis, associated malignancies have potential prognostic significance in these patients. This study focused on the incidence and characteristics of preexisting, coexisting and subsequent malignancies in patients with ampullary carcinoma.
  
  
  METHODS
  Sixty-four cases of ampullary carcinoma were retrospectively identified. Fifty-four patients underwent surgical resection, while in the other ten, histological diagnosis was reached after biopsy and/or autopsy. Other primary malignancies associated with ampullary carcinoma, occurring in the prediagnostic or postdiagnostic period, were investigated. The mean postdiagnostic follow-up period was 3.9 years (range, 0-23 years).
  
  
  RESULTS
  Other malignancies occurred in 17 patients (27%), being found before (n=9), at (n=7), or after (n=5) diagnosis of ampullary carcinoma. The total number of associated lesions was 23, including one case of quadruple and four cases of triple carcinoma. The major associated malignancies were colonic carcinoma (n=9), gastric carcinoma (n=5), and uterine carcinoma (n=3). Twenty-one lesions were treated surgically or endoscopically. One patient died from synchronous extrahepatic bile duct carcinoma and one from leukemia, and one died from subsequent urinary bladder carcinoma. Development of other malignancies was related to age but not to gender, family history, adjuvant chemo/radiotherapy, or tumor pathology.
  
  
  CONCLUSIONS
  Ampullary carcinoma is associated with a high incidence of other malignancies, particularly colonic and gastric carcinomas. The possibility of associated malignancies should therefore be considered in preoperative screening and postoperative follow-up of patients with ampullary carcinoma.
authors.affiliation: Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital Tokyo, Japan. kamisawa-k@komagome-hospital.bunkyo.tokyo.jp
authors.forename: Terumi
authors.initials: T
authors.lastname: Kamisawa
authors.forename: Naoto
authors.initials: N
authors.lastname: Egawa
authors.forename: Kouji
authors.initials: K
authors.lastname: Tsuruta
authors.forename: Atsutake
authors.initials: A
authors.lastname: Okamoto
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Horiguchi
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Funata
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000473:pathology*; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery; D003138:Common Bile Duct Neoplasms / Q000473:pathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology* / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies