One of them always remained anicteric, 11 patients developed progressive jaundice, 2 of them developed clinical and laboratory fluctuating jaundice, 5 presented only laboratory fluctuating jaundice and one did not present significant variations on total [ncbi.nlm.nih.gov]

Presentation A middle aged man presents with jaundice and epigastric pain. An ultrasound scan was performed. Caption: Subcostal oblique scan Description: This image shows dilated intrahepatic bile ducts. [sonoworld.com]

• Painless Jaundice

  Case report We report the case of a 78-year-old woman with painless jaundice of recent onset. [scielo.isciii.es]

  The patient initially developed painless jaundice about 1 year previously, and was found to have a cancer of the ampulla. He sought treatment at one of the top cancer hospitals in Canada due to the rare tumour type. [medicorcancer.com]

  SYMPTOMS: The usual symptoms are painless jaundice, intermittent or constant; fatigue, pruritis, fever, and nonspecific abdominal pain. Intestinal hemorrhage or pancreatitis are also possible. [ralphmoss.com]

  Physical: The Courvoisier sign, painless jaundice associated with a palpable gallbladder, may be present. Unlike that due to a neoplasm, obstructive jaundice due to a stone causes scarring of the gallbladder, precluding its distension. [oncology-articles.blogspot.com]

• Abdominal Pain

  Most patients were admitted for obstructive jaundice (49%), right upper quadrant abdominal pain (19%), nausea and loss of appetite in 13%, loss of weight (13%) and upper digestive obstruction in 6% of cases. [ncbi.nlm.nih.gov]

  Symptoms can include Jaundice Itchy skin Fever Abdominal pain Tests to diagnose bile duct cancer may include a physical exam, imaging tests of the liver and bile ducts, blood tests, and a biopsy. [icdlist.com]

  Abstract A 28-year-old female presented with jaundice, abdominal pain and postprandial vomiting. UGI endoscopic examination demonstrated a friable polypoid ampullary mass. [ispub.com]

  pain, occasionally pancreatitis Nodal metastases at diagnosis in 35% (usually adjacent periampullary nodes) Immunohistochemically detected lymph node micrometastasis indicates intensive lymphatic spread and adversely affects the survival of patients [pathologyoutlines.com]

  He was also experiencing a significant amount of right upper quadrant abdominal pain. Findings Body weight was 70.4kg. Vital signs were normal, there was no fever. Oxygen saturation was 95% at rest. Air entry to the right lower lung was reduced. [medicorcancer.com]

• Epigastric Pain

  Presentation A middle aged man presents with jaundice and epigastric pain. An ultrasound scan was performed. Caption: Subcostal oblique scan Description: This image shows dilated intrahepatic bile ducts. [sonoworld.com]

  RESULTS Our case A 55 year-old woman presented with a three-year history of epigastric pain, weakness and weight loss. Her past medical history was unremarkamable. The physical exam showed a fixed epigastric mass measuring 5 cm without pain. [latunisiemedicale.com]

  CASE REPORT A 71-year-old Korean man was admitted to our hospital with epigastric pain and general weakness. The ocular conjunctiva was icteric. His abdomen was soft and no mass was palpable. [kjim.org]

  Progressive weight loss Epigastric pain: The abdominal pain usually is dull, aching midepigastric pain or right hypochondriac pain. Backache usually is a sign of advanced stage. [oncology-articles.blogspot.com]

• Abdominal Tenderness

  She was visibly icteric, but physical examination was otherwise unremarkable, without any abdominal tenderness or palpable breast masses. [pancreas.imedpub.com]

• Peripheral Neuropathy

  Reasons for treatment discontinuation were disease progression ( n = 11, 52%), peripheral neuropathy ( n = 3, 14%) and patient refusal ( n = 1, 5%). Efficacy All 21 patients were analyzed ( Table 3 ). [jstage.jst.go.jp]

  In particular, the peripheral neuropathy that the patient developed under oxaliplatin has not worsened but improved from grade 1-2 to grade 1. [karger.com]

• Polyneuropathy

  […] oxaliplatin and nanoparticle albumin-bound paclitaxel-induced polyneuropathy. [karger.com]

CONCLUSIONS: There are clinical scenarios in which it is quite challenging to distinguish a primary ampullary adenocarcinoma based on a preoperative workup. [ncbi.nlm.nih.gov]

We highlight such a case, and its diagnostic workup. Case Report: A 61 year old woman presented with painless obstructive jaundice of 2 months duration. MRI scan showed a stricture in the distal common bile duct suggestive of a neoplasm. [journals.sjp.ac.lk]

(ie, for staging purposes) Positron emission tomography (PET) or PET-CT scanning: PET or PET-CT scans can detect metastases that are too small to be reliably detected on a CT scan See Workup for more detail. [emedicine.medscape.com]

Choledocholithiasis Duodenal Ulcers Gallbladder Cancer Gallbladder Tumors Lymphoma, Non-Hodgkin Pancreatic Cancer Pancreatitis, Chronic Papillary Necrosis Papillary Tumors Other Problems to be Considered: Duodenal carcinoma Adenoma at the ampulla of Vater WORKUP [oncology-articles.blogspot.com]

This study will require you to receive at least 3 cycles of treatment. However, if you experience severe side effects or your disease becomes worse, treatment may be delayed, stopped, or you may receive smaller doses of the treatment. [clinicaltrials.gov]

There were no treatment-related deaths. Table 4. Treatment-related adverse events during treatment. AST, aspartate transaminase; ALT, alanine transaminase. [jstage.jst.go.jp]

There were no grade 3 or 4 nonhematologic toxicities or treatment-related deaths. [ncbi.nlm.nih.gov]

Abstract Ampullary carcinoma is a rare tumor and evidence on the treatment of recurrent metastatic disease is scarce. [karger.com]

BACKGROUND: Intestinal and pancreaticobiliary types of Vater's ampulla adenocarcinoma have been considered as having different biologic behavior and prognosis. [ncbi.nlm.nih.gov]

Treatment and prognosis In general, ampullary tumors tend to show a better prognosis than do their biliary or periampullary counterparts as they can be detected at an earlier stage owing to earlier presentation due to biliary obstruction 3. [radiopaedia.org]

The fully revised and updated Sixth Edition of the AJCC Cancer Staging Manual brings together all currently available information on staging of cancer at various anatomic sites and incorporates newly acquired knowledge on the etiology and pathology of [books.google.com]

Definition / general By definition, centered in ampulla of Vater, arises from ampullary intestinal mucosa If advanced, cannot distinguish tumor origin between ampulla, distal common bile duct or pancreas Etiology May arise from villous adenoma or villoglandular [pathologyoutlines.com]

In this theory, signet-ring cell carcinoma originates from periampullary duodenal heterotopias of an ulcerative etiology and expands to the ampulla of Vater. [joplink.net]

Causes: The etiology of the disease is poorly understood. Patients with familial adenomatous polyposis (FAP) have an increased risk of both benign and malignant ampullary tumors (Burke, 1999). [oncology-articles.blogspot.com]

METHODS: Lymph node metastasis was assessed in the Surveillance, Epidemiology and End Results database in 1,057 ampullary adenocarcinomas that were operatively resected and for which at least 12 lymph nodes were examined. [ncbi.nlm.nih.gov]

  Epidemiology,  Clinical manifestations,  Diagnosis and staging,  Treatment and prognosis. [slideshare.net]

Epidemiology of cholangiocarcinoma: an update focusing on risk factors. Cancer Sci 2010; 101: 579-585 Bosetti C, Bertuccio P, Negri E, et al. Pancreatic cancer: overview of descriptive epidemiology. [sapd.es]

Between 1973 and 2005, 5,625 cases were recorded in the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. [emedicine.medscape.com]

Cancer Epidemiology, 36(4): e207-e14. FIND OUT MORE: Thames Cancer Registry is the lead cancer registry for upper gastrointestinal cancers. Other useful resources within the NCIN partnership: Cancer Research UK CancerStats [ncin.org.uk]

Pathophysiology Periampullary carcinoma includes tumors arising in the head, neck, or uncinate process of the pancreas, tumors arising in the distal common bile duct, tumors arising in the duodenum, as well as tumors arising from the ampulla of Vater. [emedicine.medscape.com]

Pathophysiology: Ninety percent of ampullary tumors are adenocarcinomas. Neuroendocrine tumors, cystadenomas, and adenomas represent additional, but uncommon, histologic types. [oncology-articles.blogspot.com]

Updated meta-analysis of pancreatic stent placement in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis. World J Gastroenterol 2015;21:7577–83. [link.springer.com]

[…] through the ampulla: the sphincter of the pancreatic duct, the sphincter of the bile duct, and the sphincter of Oddi. [ citation needed ] The sphincter of Oddi controls the introduction of bile and pancreatic secretions into the duodenum, as well as preventing [en.wikipedia.org]

Read Full Post 3/13/2019 12:00 AM Lifestyle changes that may reduce your risk of cancer Studies reported by the National Institutes of Health have found that at least 75 to 80 percent of cancers in the United States may be prevented by lifestyle changes [cancercenter.com]

We gave the patient routine supplementation with R alpha lipoic acid 150mg t.i.d. and benfotiamine 80mg b.i.d. to help prevent DCA side effects. Within 1 week, the patient’s fevers disappeared. [medicorcancer.com]

A gastrojejunostomy also should be performed in patients with a compromised duodenal lumen to prevent gastric outlet obstruction before death. [slideplayer.com]