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A case of small cell neuroendocrine carcinoma of the ampulla of Vater

BACKGROUND: Gastroenteric neuroendocrine carcinomas (NECs) account for 6.2% of gastroenteric neuroendocrine tumors (NETs), and only 1% or less of gastroenteric NETs occur in the ampulla of Vater (AoV). Clinical features of NEC of the AoV remain obscure. CASE PRESENTATION: A 65-year-old man visited a...

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Autores principales: Ito, Hiroharu, Wada, Yoshiyuki, Takami, Yuko, Ryu, Tomoki, Ureshino, Hiroki, Imamura, Hajime, Sasaki, Shin, Ohno, Akihisa, Hijioka, Masayuki, Kaku, Toyoma, Kawabe, Ken, Kawauchi, Shigeto, Saitsu, Hideki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320127/
https://www.ncbi.nlm.nih.gov/pubmed/32592083
http://dx.doi.org/10.1186/s40792-020-00915-9
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author Ito, Hiroharu
Wada, Yoshiyuki
Takami, Yuko
Ryu, Tomoki
Ureshino, Hiroki
Imamura, Hajime
Sasaki, Shin
Ohno, Akihisa
Hijioka, Masayuki
Kaku, Toyoma
Kawabe, Ken
Kawauchi, Shigeto
Saitsu, Hideki
author_facet Ito, Hiroharu
Wada, Yoshiyuki
Takami, Yuko
Ryu, Tomoki
Ureshino, Hiroki
Imamura, Hajime
Sasaki, Shin
Ohno, Akihisa
Hijioka, Masayuki
Kaku, Toyoma
Kawabe, Ken
Kawauchi, Shigeto
Saitsu, Hideki
author_sort Ito, Hiroharu
collection PubMed
description BACKGROUND: Gastroenteric neuroendocrine carcinomas (NECs) account for 6.2% of gastroenteric neuroendocrine tumors (NETs), and only 1% or less of gastroenteric NETs occur in the ampulla of Vater (AoV). Clinical features of NEC of the AoV remain obscure. CASE PRESENTATION: A 65-year-old man visited a general practitioner because of jaundice, and an abdominal contrast-enhanced computed tomography scan revealed a tumor of 11 mm in diameter, which was enhanced in the arterial phase at the duodenal papilla, with dilation of the upstream bile duct. Gastrointestinal scope revealed an unexposed tumor of the AoV. Based on a biopsy of the site, a moderately differentiated tubular adenocarcinoma was suspected, and pancreatoduodenectomy was performed. Histopathological examination revealed dysplasia and highly proliferative small tumor cells, with solid and nodular formation at the AoV. Histological analysis showed a high mitotic count, and immunohistochemical staining revealed a Ki-67 index of 40–50% and cells positive for synaptophysin, chromogranin A, and p53. Small cell-type NEC was finally diagnosed. Four months post pancreatoduodenectomy, multiple liver metastases developed, and systemic chemotherapy was administered. Salvage liver resection for liver metastases was performed 14 months after the pancreatoduodenectomy. Unfortunately, multiple liver metastases developed 2 months after liver resection, and the patient died 18 months after the pancreatoduodenectomy. CONCLUSIONS: Neuroendocrine carcinoma originating from the bile duct is very rare; therefore, in this article, we provide a review of the literature and a case report.
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spelling pubmed-73201272020-07-01 A case of small cell neuroendocrine carcinoma of the ampulla of Vater Ito, Hiroharu Wada, Yoshiyuki Takami, Yuko Ryu, Tomoki Ureshino, Hiroki Imamura, Hajime Sasaki, Shin Ohno, Akihisa Hijioka, Masayuki Kaku, Toyoma Kawabe, Ken Kawauchi, Shigeto Saitsu, Hideki Surg Case Rep Case Report BACKGROUND: Gastroenteric neuroendocrine carcinomas (NECs) account for 6.2% of gastroenteric neuroendocrine tumors (NETs), and only 1% or less of gastroenteric NETs occur in the ampulla of Vater (AoV). Clinical features of NEC of the AoV remain obscure. CASE PRESENTATION: A 65-year-old man visited a general practitioner because of jaundice, and an abdominal contrast-enhanced computed tomography scan revealed a tumor of 11 mm in diameter, which was enhanced in the arterial phase at the duodenal papilla, with dilation of the upstream bile duct. Gastrointestinal scope revealed an unexposed tumor of the AoV. Based on a biopsy of the site, a moderately differentiated tubular adenocarcinoma was suspected, and pancreatoduodenectomy was performed. Histopathological examination revealed dysplasia and highly proliferative small tumor cells, with solid and nodular formation at the AoV. Histological analysis showed a high mitotic count, and immunohistochemical staining revealed a Ki-67 index of 40–50% and cells positive for synaptophysin, chromogranin A, and p53. Small cell-type NEC was finally diagnosed. Four months post pancreatoduodenectomy, multiple liver metastases developed, and systemic chemotherapy was administered. Salvage liver resection for liver metastases was performed 14 months after the pancreatoduodenectomy. Unfortunately, multiple liver metastases developed 2 months after liver resection, and the patient died 18 months after the pancreatoduodenectomy. CONCLUSIONS: Neuroendocrine carcinoma originating from the bile duct is very rare; therefore, in this article, we provide a review of the literature and a case report. Springer Berlin Heidelberg 2020-06-26 /pmc/articles/PMC7320127/ /pubmed/32592083 http://dx.doi.org/10.1186/s40792-020-00915-9 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Case Report
Ito, Hiroharu
Wada, Yoshiyuki
Takami, Yuko
Ryu, Tomoki
Ureshino, Hiroki
Imamura, Hajime
Sasaki, Shin
Ohno, Akihisa
Hijioka, Masayuki
Kaku, Toyoma
Kawabe, Ken
Kawauchi, Shigeto
Saitsu, Hideki
A case of small cell neuroendocrine carcinoma of the ampulla of Vater
title A case of small cell neuroendocrine carcinoma of the ampulla of Vater
title_full A case of small cell neuroendocrine carcinoma of the ampulla of Vater
title_fullStr A case of small cell neuroendocrine carcinoma of the ampulla of Vater
title_full_unstemmed A case of small cell neuroendocrine carcinoma of the ampulla of Vater
title_short A case of small cell neuroendocrine carcinoma of the ampulla of Vater
title_sort case of small cell neuroendocrine carcinoma of the ampulla of vater
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320127/
https://www.ncbi.nlm.nih.gov/pubmed/32592083
http://dx.doi.org/10.1186/s40792-020-00915-9
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