title: Mixed adenoneuroendocrine carcinoma of the ampulla: two case reports.
abstract: Mixed adenoneuroendocrine carcinoma (MANEC) is a malignant tumor with adenocarcinoma and neuroendocrine components, with ≥30% of each component required. MANEC of the ampulla is rare. To the best of our knowledge, only 15 cases of MANEC of the ampulla have been reported in the English-language literature. Here, we report two cases of MANEC of the ampulla in two women aged 43 and 60 years, which was confirmed by histology after pancreaticoduodenectomy. These tumors contained neuroendocrine and adenocarcinoma components. The neuroendocrine components were positive for chromogranin A (CgA), synaptophysin (Syn) and CD56 by immunostaining. The adenocarcinoma components were negative for CgA, Syn and CD56. Both cases were T3N0M0 (Stage IIIA). They survived for 15 and 20 mo after surgery, respectively. A brief discussion about the histopathological features, clinical behavior and treatment of MANEC of ampulla, and review of the relevant literature are presented.
authors.affiliation: Zhen Huang, Wei-Dong Xiao, Yong Li, Jun Cai, Jian Ao, Department of General Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Zhen Huang, Wei-Dong Xiao, Yong Li, Jun Cai, Jian Ao, Department of General Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Xiao
authors.affiliation: Zhen Huang, Wei-Dong Xiao, Yong Li, Jun Cai, Jian Ao, Department of General Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Li
authors.affiliation: Zhen Huang, Wei-Dong Xiao, Yong Li, Jun Cai, Jian Ao, Department of General Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.
authors.forename: Song
authors.initials: S
authors.lastname: Huang
authors.affiliation: Zhen Huang, Wei-Dong Xiao, Yong Li, Jun Cai, Jian Ao, Department of General Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Cai
authors.affiliation: Zhen Huang, Wei-Dong Xiao, Yong Li, Jun Cai, Jian Ao, Department of General Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Ao
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D000328:Adult; D014670:Ampulla of Vater / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003138:Common Bile Duct Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D018193:Neoplasms, Complex and Mixed / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D018358:Neuroendocrine Tumors / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor
keywords: Ampulla; Composite carcinoma; Immunohistochemical; Mixed adenoneuroendocrine carcinoma; Neuroendocrine tumor