title: Large cell neuroendocrine carcinoma of the ampulla of vater: Report of a case.
abstract: Large cell neuroendocrine carcinoma in the ampulla of Vater is rare and very different from the common ampullary adenocarcinoma. A 59-year-old man was admitted with obstructive jaundice. Gastroendoscopy showed a swollen ampulla of Vater and pathological examination of an ampullary biopsy revealed findings of a carcinoid tumor. After endoscopic biliary drainage, he underwent pancreaticoduodenectomy. A diagnosis of large cell neuroendocrine carcinoma was confirmed by immunohistochemical examination of the resected specimen. Despite adjuvant chemotherapy with cyclophosphamide and cisplatin, liver and peritoneal metastasis developed within 5 months and he survived for only 10 months after the operation. Thus, further investigations are needed to find a more effective postoperative adjuvant chemotherapy agent to treat patients with this aggressive tumor.
authors.affiliation: Department of Surgery, Taichung Veterans General Hospital, Section 3, 160 Chung-Kang Road, Taichung, Taiwan.
authors.forename: So-Sen
authors.initials: SS
authors.lastname: Huang
authors.forename: Yee-Jee
authors.initials: YJ
authors.lastname: Jan
authors.forename: Shao-Bin
authors.initials: SB
authors.lastname: Cheng
authors.forename: Dah-Cherng
authors.initials: DC
authors.lastname: Yeh
authors.forename: Cheng-Chung
authors.initials: CC
authors.lastname: Wu
authors.forename: Tse-Jia
authors.initials: TJ
authors.lastname: Liu
authors.forename: Fang-Ku
authors.initials: FK
authors.lastname: P'eng
mesh_terms: D014670:Ampulla of Vater; D001706:Biopsy; D018287:Carcinoma, Large Cell / Q000473:pathology* / Q000601:surgery; D018278:Carcinoma, Neuroendocrine / Q000473:pathology* / Q000601:surgery; D003138:Common Bile Duct Neoplasms / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy