ampullary carcinoma

(redirected from carcinoma of the ampulla of Vater)

ampullary carcinoma

A rare GI tract tumour that arises in the last centimetre of the common bile duct, comprising 7% of all periampullary malignancies. Ampullary carcinomas arise in ampullary adenomas; they usually have a better prognosis than pancreatic carcinomas, especially if the lesion is polypoid or papillary, and a worse prognosis if node-positive. The periampullary region is anatomically complex, representing the junction of three different epithelia: duodenal, pancreatic ductal, bile ductal, as well as a combination of the latter two (the ampulla of Vater).

Location
Intra-ampullary, periampullary, mixed, invasive pancreatic carcinoma.

Pathophysiology
Distinguishing between ampullary and periampullary tumours is critical, given that each type of mucosa produces a different pattern of mucus secretion (and prognosis): in general, ampullary tumours produce sialomucins and have a 100% 5-year survival, whereas periampullary tumours secrete sulfphated mucins and a 27% 5-year survival rate. Ampullary adenocarcinomas are classified as either:
(1) pancreaticobiliary—more aggressive, like that of pancreatic adenocarcinomas, CA 19-9 +ve; or
(2) intestinal—which have a prognosis similar to their duodenal counterparts, CA 19-9 –ve.
Mentioned in ?
References in periodicals archive ?
Adenosquamous carcinoma of the ampulla of Vater A report of two cases.
A case of adenosquamous cell carcinoma of the ampulla of Vater.
Out of the 9 patients of periampullary carcinoma, 4 patients had carcinoma of the head of the pancreas; 4 patients had carcinoma of the ampulla of vater, 1 patient had distal cholangiocarcinoma.
Patterns and predictors of failure after curative resections of carcinoma of the ampulla of Vater.
Composite papillary intestinal-type adenocarcinoma/poorly differentiated neuroendocrine carcinoma of the ampulla of Vater.
Pathological factors influencing survival of carcinoma of the ampulla of Vater.
Number of lymph node metastases is significantly associated with survival in patients with radically resected carcinoma of the ampulla of Vater.

Full browser ?