A Neuroendocrine Tumor in the Ampulla of Vater along with Main-Duct Intraductal Papillary Mucinous Neoplasm

• Ashitomi Yuya

  First Department of Surgery, Yamagata University

• Watanabe Toshihiro

  First Department of Surgery, Yamagata University

• Sugawara Shuichiro

  First Department of Surgery, Yamagata University

• Ashino Koki

  First Department of Surgery, Yamagata University

• Takahashi Ryosuke

  First Department of Surgery, Yamagata University

• Nakano Ryo

  First Department of Surgery, Yamagata University

• Kabasawa Takanobu

  Department of Pathological Diagnostics, Yamagata University

• Kimura Wataru

  First Department of Surgery, Yamagata University

Bibliographic Information

Other Title

• 十二指腸乳頭部神経内分泌腫瘍に主膵管型膵管内乳頭粘液性腫瘍が併存していた1例

Abstract

A 78-year-old woman was admitted to our hospital because she had elevated levels of liver and biliary enzymes. Using contrast-enhanced CT, we observed a tumor in the ampulla of Vater and a swollen lymph node located behind the pancreatic head. These were enhanced during the hepatic arterial phase. Endoscopic US images showed a high echoic tumor in the main pancreatic duct and the swollen lymph node. We performed ERCP and observed a radiolucent region; this may be due to the presence of a papillary tumor in the main pancreatic duct. Intraductal US showed that the papillary tumor extends to the ampulla of Vater. There was an exposed protruded tumor in the ampulla of Vater; following biopsy, the tumor was diagnosed as tubulovillous adenoma. We performed pancreaticoduodenectomy and identified a neuroendocrine tumor in the ampulla of Vater that extended to the main pancreatic duct. Based on histological analysis, we confirmed that the patient had a neuroendocrine tumor in the ampulla of Vater along with a main-duct intraductal papillary mucinous neoplasm. This is a rare case, and hence, preoperative diagnosis was difficult.

Journal

• The Japanese Journal of Gastroenterological Surgery

  The Japanese Journal of Gastroenterological Surgery 52 (8), 456-464, 2019-08-01

  The Japanese Society of Gastroenterological Surgery

Keywords

• neuroendocrine tumor
• intraductal papillary mucinous neoplasm
• lymph node metastasis

Details

• CRID: 1390001288159335168
• NII Article ID: 130007696902
• DOI: 10.5833/jjgs.2018.0148
• ISSN: 13489372
• ISSN: 03869768
• Web Site: https://www.jstage.jst.go.jp/article/jjgs/52/8/52_2018.0148/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2020034987
• Text Lang: ja
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed