title: Signet ring cell carcinoma of the ampulla of vater. A case report.
abstract: BACKGROUND
  Signet ring cell carcinoma of the ampulla of Vater is extremely rare and only 12 cases have previously been described in the English language literature. We report a case of advanced signet ring cell carcinoma of the ampulla of Vater, with invasion of the duodenum and pancreas.
  
  
  METHODS
  A 59-year-old man presented at a local hospital with upper abdominal pain and icterus. Obstructive jaundice was diagnosed and he was referred to our hospital. Abdominal computed tomography showed dilatation of the common bile duct and the pancreatic duct. Duodenoscopy indicated an irregularly shaped erosion on the ampulla of Vater. Histological examination of a biopsy revealed adenocarcinoma. Duodenography revealed irregularity of the second portion of the duodenum wall. The diagnosis was carcinoma of the ampulla of Vater, and a pancreaticoduodenectomy was performed. The histopathological findings detected signet ring cell carcinoma.
  
  
  CONCLUSIONS
  Although several cases have been reported, the detailed clinicopathological features and prognosis are not clear. Additional reports are warranted.
authors.affiliation: Division of Surgery, National Hospital Organization Disaster Medical Center, Tokyo 190-0014, Japan. ishibashi_y@live.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ishibashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ito
authors.forename: Keita
authors.initials: K
authors.lastname: Omori
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Wakabayashi
mesh_terms: D014670:Ampulla of Vater / Q000473:pathology; D018279:Carcinoma, Signet Ring Cell / Q000175:diagnosis*; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis* / Q000473:pathology; D004384:Duodenoscopy; D006801:Humans; D008297:Male; D008875:Middle Aged