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Neoplasm of Ampulla of Vater


Presentation

  • Subjects presented with 52 intestinal-type adenomas (low/high grade, 32:20) and 4 noninvasive pancreatobiliary papillary neoplasms (low/high grade, 1:3).[ncbi.nlm.nih.gov]
  • Furthermore, the local resection of ampullary NETs is technically difficult and presents significant morbidity [ 28 , 29 ].[pancreas.imedpub.com]
  • Most patients with an ectopic pancreas are asymptomatic, and, if present, symptoms are nonspecific and depend on the site of the lesion and the different complications encountered.[ncbi.nlm.nih.gov]
  • Flat intraepithelial neoplasia presents as a flat or superficial, spreading, mucosal lesion that is frequently accompanied by an invasive carcinoma.[ncbi.nlm.nih.gov]
  • The data included age, sex, presenting symptoms, preoperative imaging, preoperative type of biopsy results, type of operation, pathologic findings and survival status. RESULTS: The patient's mean age was 55.2 9.7 years.[ncbi.nlm.nih.gov]
Asymptomatic
  • Most patients with an ectopic pancreas are asymptomatic, and, if present, symptoms are nonspecific and depend on the site of the lesion and the different complications encountered.[ncbi.nlm.nih.gov]
  • The patient progressed uneventfully and, after seven years following the operation, he is asymptomatic with a normal serum chromogranin A level. Figure 1: Photomicrograph of a neuroendocrine tumor of the ampulla of Vater.[pancreas.imedpub.com]
Plethora
  • There are a plethora of terminologies that describe precursor lesions of the pancreatobiliary tract, ampulla of Vater, and gallbladder. The current terminologies for precursor lesions may make it difficult to understand the tumor biology.[ncbi.nlm.nih.gov]
Melena
  • The 56-year-old male patient concerned visited our emergency room with melena that started one week prior to hospitalization. The patient was diagnosed to have a tumor in the ampulla of Vater with bleeding on its surface.[ncbi.nlm.nih.gov]
  • The silver colored stool is a combination of the white stool of obstructive jaundice combined with black stool of melena or bleeding. It was first described in the British Medical Journal by Dr. H.[en.wikipedia.org]
Hepatomegaly
  • […] either cause a continuous obstruction or an intermittent obstruction by a ball-valve mechanism thereby causing upper quadrant pain, jaundice and recurrent attacks of pancreatitis. 4 Icterus, evidence of scratch marks all over the body due to pruritus, hepatomegaly[bioline.org.br]

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]

Treatment

  • 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.de]
  • Treatments include surgery, radiation therapy, and chemotherapy.[icdlist.com]
  • […] delivered before or after the primary treatment, to help increase the treatment's chance of success and decrease the risk of recurrence.[cancercenter.com]
  • CONCLUSION: This tumor has precise clinical implications, and if continuous follow up is conducted after careful diagnosis and surgical treatment, invasive major operations, such as, radical pancreaticoduodenectomy can be avoided.[ncbi.nlm.nih.gov]
  • 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]

Prognosis

  • Tumours that are less than 2 cm or limited to the ampulla appear to have a better prognosis.[ncbi.nlm.nih.gov]
  • Neuroendocrine tumors of the ampulla of Vater: presentation, pathology and prognosis. JOP 2012; 13:263-7. [PMID: 22572129] Relles D, Baek J, Witkiewicz A, Yeo CJ.[pancreas.imedpub.com]
  • 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]
  • .  Prognosis better for ampullary carcinomas.[slideshare.net]
  • 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]

Etiology

  • 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]

Epidemiology

  • METHODS: This retrospective comparative cohort study used the Surveillance, Epidemiology, and End Results (SEER) registry from 1988 to 2009. OS was evaluated using Kaplan-Meier estimates and Cox proportional hazard regression.[ncbi.nlm.nih.gov]
  • .   Epidemiology,  Clinical manifestations,  Diagnosis and staging,  Treatment and prognosis.[slideshare.net]
  • One hundred years after "carcinoid": epidemiology of and prognostic factors for neuroendocrine tumors in 35, 825 cases in the United States. J Clin Oncol 2008; 26:3063-72. [PMID: 18565894][pancreas.imedpub.com]
  • 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]
Sex distribution
Age distribution

Prevention

  • Malignant neoplasm of ampulla of vater Malignant neoplasm of ampulla of vater (cancer tumour of union of the pancreatic duct and the common bile duct) has been reported by people with type 2 diabetes, rheumatoid arthritis, diabetes, high blood pressure, preventive[ehealthme.com]
  • Read Full Post 1/2/2019 12:00 AM Busting myths: Can coffee cause, cure or prevent cancer? Can coffee cause cancer or prevent it? Learn some of the myths and realities when it comes to coffee and cancer.[cancercenter.com]
  • Because of its location, this cancer can cause obstruction of the common bile duct and prevent bile from flowing into the intestine and out of the body.[medicinenet.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]
  • 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]

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