Pedunculated early ampullary carcinoma treated by ampullectomy: report of a case.
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.
Shiba
Hiroaki
H
Department of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan. hs0817@jikei.ac.jp
Misawa
Takeyuki
T
Wakiyama
Shigeki
S
Iida
Tomonori
T
Ishida
Yuichi
Y
Yanaga
Katsuhiko
K
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