Presentation
We report a rare case of SRCC of the ampulla of Vater in a 38-year-old woman who presented with a small tumor at the Vater, discovered by the contrast-enhanced ultrasound (CEUS). Histopathological examination showed prominent signet-ring features. [ncbi.nlm.nih.gov]
Of all 162 patients with ampullary lesions, eight cases (4.9%) were diagnosed as SRC, with a mean age at presentation of 60 years. The presenting symptoms information was available for all eight cases. [spandidos-publications.com]
Case presentation The patient was a 61-year-old male who presented to our hospital with increased blood levels of hepatobiliary system enzymes detected during a health check-up. He had a past medical history of hypertension and appendectomy. [surgicalcasereports.springeropen.com]
We present an elderly patient with SRCC of Vater’s Ampulla without nodal metastasis. 2. Case Presentation We report the case of a 57-year-old man, admitted with jaundice, abdominal pain four months ago and 10 kg weight loss. [file.scirp.org]
Given the location of these tumors, patients often present with relatively early stage disease with symptoms related to biliary obstruction. [jgo.amegroups.com]
Hematological
- Prolonged Bleeding
Alteration in coagulation profile (eg, increased prothrombin time, decreased prothrombin time, prolonged bleeding and clotting times) is common. Urine chemistry Urinalysis shows bile pigments. [oncology-articles.blogspot.com]
Entire Body System
- Ankle Swelling
There was significant bilateral ankle swelling. There were multiple abnormalities seen on the initial blood tests (see Fig 6A). [medicorcancer.com]
- Intermittent Fever
Abstract The hepatic intermittent fever of Charcot is due to recurrent biliary obstruction with secondary infection, and is characterized by recurrent attacks of chills, fever and sweats. Jaundice is variable and may deepen after each paroxysm. [annals.org]
Cardiovascular
- Mitral Valve Prolapse
Moreover, the symptoms of mitral valve prolapse-associated heart failure worsened at this time and continuation of chemotherapy became difficult. The patient died of the primary disease 15 months postoperatively. [surgicalcasereports.springeropen.com]
Liver, Gall & Pancreas
- Jaundice
Most patients with ampullary cancer present with jaundice. The tumor obstructs the flow of pancreatic and biliary juices into the intestine. This results in the development of a type of jaundice called obstructive jaundice. [medindia.net]
The patient was hospitalized for right upper quadrant abdominal pain and jaundice which had developed 10 days prior. Computed tomography (CT) and ultrasonography (US) revealed dilatation of the common bile duct and the intrahepatic bile duct. [e-ce.org]
Jaundice is variable and may deepen after each paroxysm. Abdominal pain, which is sometimes severe and colicky, is frequently absent. [annals.org]
Though fluctuant jaundice is supposed to be typical of periampullary carcinoma, it is progressive jaundice that is more common. [bioline.org.br]
Jaundice results when the drainage of bile into the duodenum is blocked causing it to accumulate in in the bloodstream. Jaundice, the yellowing of the skin, is typically one of the first symptoms present with Ampullary cancer. [surgery.ucsf.edu]
Workup
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]
Treatment
Fig. 6A – pre-treatment blood tests Treatment We offered a comprehensive approach to properly manage the pain, improve nutritional status and treat the cancer. [medicorcancer.com]
New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer. National Cancer Institute of the United States. National Cancer Institute of Canada. [books.google.com]
Adjuvant chemotherapy may be appropriate in the treatment of ampullary SRCC associated with locoregional metastasis. [file.scirp.org]
Patients returned to clinic for follow-up approximately every 3 months following treatment. [jgo.amegroups.com]
Prognosis
As for prognosis, Hara et al ( 12 ) showed that SRC localized in the ampulla of Vater has a poor prognosis and lymph node involvement is also regarded as a key prognostic factor. [spandidos-publications.com]
Perineural, vascular, and lymphatic invasion are associated with a poor prognosis. Liver is the most common site (66%) of distant metastasis, followed by lymph nodes (22%). In advanced cases, lung metastasis also may occur. [thehealthscience.com]
Accumulation of p53 protein and the Ki-67 labeling index revealed no significant difference in prognosis. [nature.com]
On the other hand, undifferentiated carcinoma of the common bile duct grew in a polypoid pattern and could be discovered in an early stage, leading to favorable prognosis [ 3 ]. [surgicalcasereports.springeropen.com]
SRCC localized in other digestive organs have a poor prognosis. The experience from previously reported cases of carcinoma of the ampulla of Vater suggests a good prognosis, provided there is no metastasis at the time of surgery [2]. [file.scirp.org]
Etiology
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]
In this theory, signet-ring cell carcinoma originates from periampullary duodenal heterotopias of an ulcerative etiology and expands to the ampulla of Vater. [file.scirp.org]
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]
Epidemiology
Between 1973 and 2005, 5,625 cases were recorded in the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. [thehealthscience.com]
Epidemiology, Clinical manifestations, Diagnosis and staging, Treatment and prognosis. [slideshare.net]
胆嚢癌 (GBC) の予測:主要18市場 Epiomic Epidemiology Series: Gallbladder Cancer Forecast in 18 Major Markets 2015-2025 出版日: 2015年09月16日 ページ情報: 英文 62 Pages 概要 胆嚢癌 (GBC) は、主に胆嚢自体に発生するだけでなく、肝外胆管や、ファーター膨大部、指定されていない胆管腫瘍なども含まれます。 [gii.co.jp]
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]
Pathophysiology
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. [thehealthscience.com]
Pathophysiology: Ninety percent of ampullary tumors are adenocarcinomas. Neuroendocrine tumors, cystadenomas, and adenomas represent additional, but uncommon, histologic types. [oncology-articles.blogspot.com]
Prevention
Prevention Ampullary cancer is such a rare condition that experts aren’t sure what steps, if any, can be taken to prevent it. It does appear to be more common among men than women. [essentiahealth.org]
[…] 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]
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]
Deterrence/Prevention: Those with FAP and their family members should be counseled about the possibility of acquiring ampullary carcinoma. [oncology-articles.blogspot.com]
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]