title: Coexistent ampullary squamous cell carcinoma with adenocarcinoma of the pancreatic duct.
abstract: Primary squamous cell carcinoma (SCC) of ampulla has seldom been reported. However, metastatic SCC to ampulla of Vater is well known. We report a case of primary SCC of ampulla of Vater coexistent with well-differentiated adenocarcinoma of the distal pancreatic duct. A 50-year-old female presented with evidence of obstructive jaundice. Endoscopic retrograde cholangio-pancreatography revealed bulging papilla with ulcero-infiltrative growth at the ampulla of Vater. An initial endoscopic biopsy of the ampullary mass showed a well-differentiated SCC. The patient underwent Whipple's operation. Thorough sampling of the dilated portion of the pancreatic duct showed presence of well-differentiated adenocarcinoma of the distal pancreatic duct. Immunohistochemical study with synaptophysin and chromogranin was done with negative result, ruling out neuroendocrine differentiation. Also, a detailed clinical, endoscopic and radiological examination was carried out, that excluded the presence of primary SCC elsewhere.
authors: Department of Pathology and Surgery, Shrimati Kashibai Navale Medical College and General Hospital, Narhe, Pune, India. drgayatridp@yahoo.in
authors: Gayatri S
authors: GS
authors: Pathak
authors: Sanjay D
authors: SD
authors: Deshmukh
authors: Prasanna A
authors: PA
authors: Yavalkar
authors: Amrut V
authors: AV
authors: Ashturkar
mesh_terms: D014670:Ampulla of Vater / Q000473:pathology* / Q000601:surgery; D001706:Biopsy; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000601:surgery; D002294:Carcinoma, Squamous Cell; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000379:methods*