Inflammatory pseudotumour arising from periampullary carcinoid: a "cancer-like" tumour in a "fake" tumour.
Carcinoid tumours of the gastrointestinal tract are uncommon, generally slow-growing and associated with a good prognosis. We present a 52-year-old Chinese woman with a carcinoid at the ampulla of Vater, a site far less common than other areas of the gastrointestinal tract. Preoperative imaging showed a pancreatic mass with displacement and possible invasion of the portal vein associated with peripancreatic nodal enlargement. A radical pancreaticoduodenectomy with portal vein wedge excision was performed. An intraoperative biopsy of the enlarged nodes was negative for malignancy and postoperative histology of the large pancreatic mass yielded a surprising finding of a carcinoid tumour at the ampulla of Vater with a large inflammatory pancreatic mass adherent to the portal vein. This is an uncommon case associated with "pseudotumour pancreatitis", causing biliary and pancreatic duct obstruction mimicking a large tumour in the head of the pancreas.
Department of Surgery, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074. surv7@nus.edu.sg
S K Y
SK
Chang
W T M
WT
Liang
T P
TP
Thamboo
D014670:Ampulla of Vater / Q000473:pathology*; D002276:Carcinoid Tumor / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005706:Gallbladder Neoplasms / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D006104:Granuloma, Plasma Cell / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D011379:Prognosis