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Neuroendocrine carcinoma of the ampulla of Vater: a case report, review and recommendations

Neuroendocrine tumor (NET) of the ampulla of Vater is a rare presentation of biliary obstruction. Here, we present a case of NET and discuss the current recommendations that necessitate different management and surgical treatment than other sites. A 56-year-old Caucasian female presented with 2 year...

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Autores principales: Kleinschmidt, Thomas K, Christein, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276669/
https://www.ncbi.nlm.nih.gov/pubmed/32537123
http://dx.doi.org/10.1093/jscr/rjaa119
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author Kleinschmidt, Thomas K
Christein, John
author_facet Kleinschmidt, Thomas K
Christein, John
author_sort Kleinschmidt, Thomas K
collection PubMed
description Neuroendocrine tumor (NET) of the ampulla of Vater is a rare presentation of biliary obstruction. Here, we present a case of NET and discuss the current recommendations that necessitate different management and surgical treatment than other sites. A 56-year-old Caucasian female presented with 2 years of right upper quadrant pain. Workup revealed a well-differentiated 2.2 cm NET at the ampulla with 0 MF/10 HPF, Stage 1A T2NOMO. Whipple procedure performed with 2.2 cm ampullary NET with 1 of the 15 lymph node metastases and <2 mitoses in 10 HPF. TNM classification: Stage IV T2N1MO. Regardless of tumor size, NETs metastasize in half of cases. Local excisions including endoscopic and laparoscopic ampullectomy were recommended only for poor surgical candidates. Ampullary NETs behave more aggressively than nonampullary NETs and their biological behaviors are irrespective of size. For patients of acceptable surgical risk, we recommend radical resection utilizing Whipple procedure.
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spelling pubmed-72766692020-06-12 Neuroendocrine carcinoma of the ampulla of Vater: a case report, review and recommendations Kleinschmidt, Thomas K Christein, John J Surg Case Rep Case Report Neuroendocrine tumor (NET) of the ampulla of Vater is a rare presentation of biliary obstruction. Here, we present a case of NET and discuss the current recommendations that necessitate different management and surgical treatment than other sites. A 56-year-old Caucasian female presented with 2 years of right upper quadrant pain. Workup revealed a well-differentiated 2.2 cm NET at the ampulla with 0 MF/10 HPF, Stage 1A T2NOMO. Whipple procedure performed with 2.2 cm ampullary NET with 1 of the 15 lymph node metastases and <2 mitoses in 10 HPF. TNM classification: Stage IV T2N1MO. Regardless of tumor size, NETs metastasize in half of cases. Local excisions including endoscopic and laparoscopic ampullectomy were recommended only for poor surgical candidates. Ampullary NETs behave more aggressively than nonampullary NETs and their biological behaviors are irrespective of size. For patients of acceptable surgical risk, we recommend radical resection utilizing Whipple procedure. Oxford University Press 2020-06-05 /pmc/articles/PMC7276669/ /pubmed/32537123 http://dx.doi.org/10.1093/jscr/rjaa119 Text en Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Report
Kleinschmidt, Thomas K
Christein, John
Neuroendocrine carcinoma of the ampulla of Vater: a case report, review and recommendations
title Neuroendocrine carcinoma of the ampulla of Vater: a case report, review and recommendations
title_full Neuroendocrine carcinoma of the ampulla of Vater: a case report, review and recommendations
title_fullStr Neuroendocrine carcinoma of the ampulla of Vater: a case report, review and recommendations
title_full_unstemmed Neuroendocrine carcinoma of the ampulla of Vater: a case report, review and recommendations
title_short Neuroendocrine carcinoma of the ampulla of Vater: a case report, review and recommendations
title_sort neuroendocrine carcinoma of the ampulla of vater: a case report, review and recommendations
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276669/
https://www.ncbi.nlm.nih.gov/pubmed/32537123
http://dx.doi.org/10.1093/jscr/rjaa119
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