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.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.
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References in periodicals archive ?
Since long-term survival of carcinoma of the ampulla of Vater depends on lymph node metastasis, pancreaticoduodenectomy remains the gold-standard treatment, as it is currently believed to better address the high rate of lymphovascular invasion and lymph node metastasis observed for this disease (44).
Caption: Figure 6: Gradual fracture of a biliary stent in a 78-year-old woman with common bile duct obstruction secondary to carcinoma of the ampulla of Vater. (a).
Matsusue, "Pancreaticoduodenectomy for carcinoma of the ampulla of Vater with common hepatic artery originated from hepatomesenteric trunk, passing through the pancreatic head: report of a case (in Japanese)," Japanese Journal of Gastroenterological Surgery, vol.
Primary squamous cell carcinoma of the ampulla of Vater: A case report.
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.
Carcinoma of the ampulla of Vater: factors influencing long-term survival of 127 patients with resection.
Signet ring cell carcinoma of the ampulla of Vater: a case report.
After hearing about the resection of a neuroendocrine tumor, Whipple saw a reason in a more aggressive approach in patients with carcinoma of the ampulla of Vater and also described a two-step approach.
Composite papillary intestinal-type adenocarcinoma/poorly differentiated neuroendocrine carcinoma of the ampulla of Vater. J Clin Pathol.
Pathological factors influencing survival of carcinoma of the ampulla of Vater. Eur J Surg Oncol.
Carcinoma of the ampulla of vater: a clinicopathologic study and pathologic staging of 109 cases of carcinoma and 5 cases of adenoma.

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