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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...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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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. |
format | Online Article Text |
id | pubmed-7276669 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
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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