Journal of the Chinese Medical Association
Volume 71, Issue 10 , Pages 536-540, October 2008

Coexistence of Large Cell Neuroendocrine Carcinoma and Adenocarcinoma of the Ampulla of Vater

  • Shih-Hao Liu

      Affiliations

    • Corresponding Author InformationCorrespondence to: Dr Shih-Hao Liu, Department of Pathology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.
    • ,
  • Shyh-Haw Tsay

Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.

Received 24 December 2007; accepted 23 May 2008.

Article Outline

We report a case of coexisting poorly differentiated endocrine carcinoma and conventional adenocarcinoma in the ampulla of Vater. A 70-year-old female had a recent history of symptoms and signs related to obstructive jaundice. An initial endoscopic biopsy of the ampulla of Vater showed a poorly differentiated endocrine carcinoma in the lamina propria of duodenal mucosa. The tumor could also be categorized into large cell neuroendocrine carcinoma under the WHO classification of pulmonary neuroendocrine tumors. The patient underwent Whipple's operation. After thorough microscopic examination of the ampulla of Vater, we incidentally found another conventional adenocarcinoma on the inner side of the duodenal papilla, and the tumor collided with the aforementioned carcinoma. The association of neuroendocrine tumor and adenocarcinoma has been reported in a few case reports and a small series. We also review the literature concerning large cell neuroendocrine carcinoma in this area.

Key Words:  adenocarcinoma , ampulla of Vater , endocrine carcinoma

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PII: S1726-4901(08)70164-3

doi:10.1016/S1726-4901(08)70164-3

Journal of the Chinese Medical Association
Volume 71, Issue 10 , Pages 536-540, October 2008

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