title: Pedunculated early ampullary carcinoma treated by ampullectomy: report of a case.
abstract: METHODS
  A 30-year-old woman was admitted to our hospital for treatment of an ampullary tumor. Upper gastrointestinal endoscopy revealed a pedunculated tumor in the ampulla of Vater with a diameter of 50 mm, which was biopsied and diagnosed as tubulovillous adenoma with moderate atypia. Endoscopic ultrasonography demonstrated a hypoechoic tumor limited to the mucosa and without evidence of lymph node metastasis. Since endoscopic resection was not indicated because of the large size and pedunculated morphology with a long stalk, the patient underwent ampullectomy and papilloplasty. Histological examination revealed well-differentiated tubular adenocarcinoma in tubular adenoma with severe atypia limited to the mucosa. The patient remains well with no evidence of recurrence 10 months after resection.
  
  
  CONCLUSIONS
  Ampullectomy is an established method for ampullary tumor, but such a tumor with a long stalk is rare.
authors.affiliation: Department of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan. hs0817@jikei.ac.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shiba
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Misawa
authors.forename: Shigeki
authors.initials: S
authors.lastname: Wakiyama
authors.forename: Tomonori
authors.initials: T
authors.lastname: Iida
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ishida
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D000328:Adult; D014670:Ampulla of Vater / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002758:Cholangiography; D003138:Common Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D016896:Treatment Outcome; D014463:Ultrasonography