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1. Liu N, Liang H, Li Q, Wang DC, Zhang RP, Wang JC, Hao XS: [Determinants of long-term survival in 38 patients with carcinoma of ampulla of Vater treated by local resection]. Zhonghua Zhong Liu Za Zhi; 2005 Oct;27(10):629-31
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Determinants of long-term survival in 38 patients with carcinoma of ampulla of Vater treated by local resection].
  • OBJECTIVE: To investigate determinants of long-term survival for carcinoma of ampulla of Vater treated by local resection.
  • On deciding for resection, the common bile duct was probe explored which guided the circumferential ring resection 1 cm, away from the tumor, including all layers of duodenum, ampula and partial bile and terminal pancreatic ducts and the posterial wall of duodenum was completed in steps.
  • The tumour size, tumour grading, lymph node status and UICC stage were significant prognostic factors in univariate analysis.
  • Preferably it is indicated only in high risk patients with a pT1 and well differentiated ampullary cancer smaller than 1 cm in diameter.
  • [MeSH-major] Adenocarcinoma / surgery. Ampulla of Vater / surgery. Common Bile Duct Neoplasms / surgery

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  • (PMID = 16438877.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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2. Leung VK, Lee SW, Yuen NW, Kung NN, Loke TK: Epigastric pain in a patient with neurofibromatosis type 1. Hong Kong Med J; 2005 Jun;11(3):213-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Patients with neurofibromatosis type 1 are at increased risk of developing carcinoid tumours of the duodenum, particularly in the ampulla of Vater.
  • Aggressive surgery with pancreatoduodenectomy is recommended for all ampullary carcinoid tumours because of their propensity to metastasise.
  • Evaluation using magnetic resonance cholangiopancreatography and side-viewing duodenoscopy revealed a submucosal tumour at the ampulla of Vater causing pancreatobiliary ductal obstruction and dilation.
  • The ampullary tumour was overlooked initially by forward-viewing endoscopy.
  • Histological examination of the surgically resected specimen confirmed the presence of a carcinoid tumour, with metastasis to peri-pancreatic lymph nodes.


3. Aksoy M, Sumer A, Sari S, Mete O, Salmaslioglu A, Erbil Y: Pancreatic ampullary carcinoma with neck metastases: a case report. Cases J; 2009;2:146
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pancreatic ampullary carcinoma with neck metastases: a case report.
  • CASE REPORT: She was diagnosed of ampullary carcinoma for which pancreatoduodenectomy was performed 14 months ago.
  • Tumor resection was performed.
  • Histopathological examination revealed the metastasis of the precedent ampullary adenocarcinoma.
  • CONCLUSION: Surgery does not improve survival for advanced metastatic ampullary cancer however, it can be mandatory in specific conditions as our patient.

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  • (PMID = 19946517.001).
  • [ISSN] 1757-1626
  • [Journal-full-title] Cases journal
  • [ISO-abbreviation] Cases J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2783102
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4. Meneghetti AT, Safadi B, Stewart L, Way LW: Local resection of ampullary tumors. J Gastrointest Surg; 2005 Dec;9(9):1300-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Local resection of ampullary tumors.
  • There is no consensus on the appropriateness of local resection for ampullary tumors, because malignant recurrence of what were thought to be benign tumors has been reported.
  • This study examined the role of local resection in the management of ampullary tumors.
  • The final pathologic diagnosis was 23 villous adenomas, six adenocarcinomas, and one paraganglioma.
  • Tumor size did not influence recurrence rate.
  • Ampullary tumors with high-grade dysplasia on preoperative biopsy should be treated by pancreaticoduodenectomy because they usually harbor malignancy.
  • Ampullary adenomas can be resected locally with good results, but the recurrence rate was 13%, so endoscopic surveillance is indicated postoperatively.
  • [MeSH-major] Ampulla of Vater / surgery. Common Bile Duct Neoplasms / surgery

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  • (PMID = 16332486.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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5. Yoon SM, Kim MH, Kim MJ, Jang SJ, Lee TY, Kwon S, Oh HC, Lee SS, Seo DW, Lee SK: Focal early stage cancer in ampullary adenoma: surgery or endoscopic papillectomy? Gastrointest Endosc; 2007 Oct;66(4):701-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Focal early stage cancer in ampullary adenoma: surgery or endoscopic papillectomy?
  • BACKGROUND: Recently, the evidence has been accumulating that endoscopic resection may be curative in treating ampullary adenoma that contains high-grade intraepithelial neoplasia/in situ tumor (HGIN/Tis).
  • However, there are only anecdotal reports of endoscopic management of "focal" T1 ampullary cancer (T1 cancer), and radical surgery is still considered the only accepted treatment modality.
  • OBJECTIVE: To assess the possibility of endoscopic papillectomy as an alternative to radical surgery for the treatment of ampullary adenoma with HGIN/Tis or focal T1 cancer.
  • PATIENTS: Twenty-three patients who had HGIN/Tis or focal T1 cancer in ampullary adenoma resected by endoscopic papillectomy and 60 patients who initially underwent radical surgery for HGIN/Tis or T1 cancer of the ampulla of Vater.
  • INTERVENTIONS: Review of medical records and analysis of surgically or endoscopically resected specimens of ampullary tumors.
  • RESULTS: Patients with HGIN/Tis of the ampulla of Vater had no lymphovascular invasion or lymph-node metastasis, and there were no occurrences of cancer or deaths during a mean (standard error [+/-SE]) 27.1 +/- 5.9 months after endoscopic papillectomy.
  • CONCLUSIONS: Endoscopic papillectomy may be a curative treatment for ampullary adenoma with HGIN/Tis and should also be considered as an alternative to surgery in focal T1 cancer in ampullary adenoma.
  • [MeSH-major] Adenoma / surgery. Ampulla of Vater. Common Bile Duct Neoplasms / surgery. Endoscopy, Gastrointestinal / methods
  • [MeSH-minor] Aged. Biopsy. Follow-Up Studies. Humans. Neoplasm Staging. Retrospective Studies. Survival Rate. Time Factors. Treatment Outcome

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  • (PMID = 17905011.001).
  • [ISSN] 0016-5107
  • [Journal-full-title] Gastrointestinal endoscopy
  • [ISO-abbreviation] Gastrointest. Endosc.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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6. Giannopoulos G, Pavlakis K, Parasi A, Kavatzas N, Tiniakos D, Karakosta A, Tzanakis N, Peros G: The expression of matrix metalloproteinases-2 and -9 and their tissue inhibitor 2 in pancreatic ductal and ampullary carcinoma and their relation to angiogenesis and clinicopathological parameters. Anticancer Res; 2008 May-Jun;28(3B):1875-81
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  • [Title] The expression of matrix metalloproteinases-2 and -9 and their tissue inhibitor 2 in pancreatic ductal and ampullary carcinoma and their relation to angiogenesis and clinicopathological parameters.
  • AIM: To investigate the expression of metalloproteinase (MMP) -2, MMP-9 and tissue inhibitor of MMP (TIMP) -2 in pancreatic ductal and ampullary carcinoma and to test the findings for correlation with angiogenesis and several clinicopathological parameters.
  • PATIENTS AND METHODS: Paraffin sections from 32 pancreatic ductal adenocarcinomas and 17 ampullary carcinomas were assessed for the expression of MMP-2, MMP-9 and TIMP-2 by immunohistochemistry.
  • The age of the patients and the degree of differentiation of the tumor were identified as independent prognostic parameters.
  • In ampullary adenocarcinoma, strong expression of glandular MMP-2 was associated with higher MVD values.
  • In ampullary adenocarcinoma, MMP-2 expression correlated with MVD, supporting its postulated role in angiogenesis.
  • [MeSH-minor] Female. Humans. Immunohistochemistry. Male. Middle Aged. Neoplasm Staging. Neovascularization, Pathologic / enzymology. Neovascularization, Pathologic / pathology

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  • (PMID = 18630474.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 127497-59-0 / Tissue Inhibitor of Metalloproteinase-2; EC 3.4.24.24 / MMP2 protein, human; EC 3.4.24.24 / Matrix Metalloproteinase 2; EC 3.4.24.35 / Matrix Metalloproteinase 9
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7. Hentati H, Arfa N, Haouas N, Landolsi S, Gharbi W, Miloudi N, Mannaï S, Ghariani B, Gharbi L, Mestiri H, Khalfallah MT: Pancreaticoduodenectomy in the elderly over 80 years: a case report. Hepatobiliary Pancreat Dis Int; 2007 Feb;6(1):104-7
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  • METHODS: An 84-year-old woman underwent pancreaticoduodenectomy for ampullary adenocarcinoma.
  • The tumor was classified pT3N0M0.
  • [MeSH-major] Adenocarcinoma / surgery. Ampulla of Vater. Common Bile Duct Neoplasms / surgery. Pancreaticoduodenectomy

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  • (PMID = 17287177.001).
  • [ISSN] 1499-3872
  • [Journal-full-title] Hepatobiliary & pancreatic diseases international : HBPD INT
  • [ISO-abbreviation] HBPD INT
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China
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8. Hsu HP, Shan YS, Hsieh YH, Yang TM, Lin PW: Predictors of recurrence after pancreaticoduodenectomy in ampullary cancer: comparison between non-, early and late recurrence. J Formos Med Assoc; 2007 Jun;106(6):432-43
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Predictors of recurrence after pancreaticoduodenectomy in ampullary cancer: comparison between non-, early and late recurrence.
  • BACKGROUND/PURPOSE: Ampullary cancer is one of the periampullary cancers with a better prognosis, but relapse still occurs early in some patients.
  • METHODS: Between January 1989 and March 2006, information was gathered on a total of 127 patients undergoing pancreaticoduodenectomy with regional lymphadenectomy for ampullary cancer at National Cheng Kung University Hospital and Tainan Municipal Hospital.
  • The early and late recurrence patients had higher levels of microscopically (R1) or macroscopically (R2) positive margin of resection and more advanced disease (advanced tumor stage, numbers of lymph nodes involved, lymph node status, pancreatic invasion and TNM stage) than the non-recurrence group.

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  • (PMID = 17588836.001).
  • [ISSN] 0929-6646
  • [Journal-full-title] Journal of the Formosan Medical Association = Taiwan yi zhi
  • [ISO-abbreviation] J. Formos. Med. Assoc.
  • [Language] ENG
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Singapore
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9. Kawabata Y, Tanaka T, Nishisaka T, Inao T, Nishi T, Yano S: Cytokeratin 20 (CK20) and apomucin 1 (MUC1) expression in ampullary carcinoma: Correlation with tumor progression and prognosis. Diagn Pathol; 2010;5:75
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cytokeratin 20 (CK20) and apomucin 1 (MUC1) expression in ampullary carcinoma: Correlation with tumor progression and prognosis.
  • BACKGROUND: We assessed the expression of cytokeratin (CK) and apomucin (MUC) in ampullary carcinoma (AC) to develop a system for the classification of ACs on the basis of their clinical significance.
  • The number of I-type carcinomas in the early tumor stages was significantly higher than the number of PB- and O-type carcinomas (p = 0.014 and p = 0.018, respectively).
  • CONCLUSIONS: The immunohistochemical subtypes based on CK and MUC expression correlated with tumor progression.
  • [MeSH-major] Ampulla of Vater / chemistry. Biomarkers, Tumor / analysis. Carcinoma / chemistry. Common Bile Duct Neoplasms / chemistry. Mucin-1 / analysis
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chi-Square Distribution. Disease Progression. Female. Humans. Immunohistochemistry. Japan. Kaplan-Meier Estimate. Keratin-20 / analysis. Male. Middle Aged. Mucin 5AC / analysis. Mucin-6 / analysis. Neoplasm Staging. Retrospective Studies. Treatment Outcome

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  • (PMID = 21106111.001).
  • [ISSN] 1746-1596
  • [Journal-full-title] Diagnostic pathology
  • [ISO-abbreviation] Diagn Pathol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / KRT20 protein, human; 0 / Keratin-20; 0 / MUC1 protein, human; 0 / MUC5AC protein, human; 0 / MUC6 protein, human; 0 / Mucin 5AC; 0 / Mucin-1; 0 / Mucin-6
  • [Other-IDs] NLM/ PMC3003636
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10. Jung MK, Cho CM, Park SY, Jeon SW, Tak WY, Kweon YO, Kim SK, Choi YH: Endoscopic resection of ampullary neoplasms: a single-center experience. Surg Endosc; 2009 Nov;23(11):2568-74
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Endoscopic resection of ampullary neoplasms: a single-center experience.
  • BACKGROUND: An ampullary tumor, whether malignant or not, must be completely resected.
  • This study aimed to evaluate the outcome of endoscopic papillectomy performed for ampullary tumors at a single center.
  • METHODS: From July 2003 to June 2008, 22 patients with a diagnosis of ampullary tumors determined by endoscopic retrograde cholangiopancreatography (ERCP) were treated using endoscopic resection of the tumors.
  • [MeSH-major] Adenoma / pathology. Adenoma / surgery. Ampulla of Vater / surgery. Cholangiopancreatography, Endoscopic Retrograde / methods. Common Bile Duct Neoplasms / pathology. Common Bile Duct Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biopsy, Needle. Chi-Square Distribution. Cohort Studies. Female. Follow-Up Studies. Humans. Immunohistochemistry. Male. Middle Aged. Minimally Invasive Surgical Procedures / adverse effects. Minimally Invasive Surgical Procedures / methods. Neoplasm Staging. Pancreaticoduodenectomy / methods. Postoperative Complications / diagnosis. Postoperative Complications / surgery. Probability. Reoperation / methods. Retrospective Studies. Risk Assessment. Sphincterotomy, Endoscopic / adverse effects. Sphincterotomy, Endoscopic / methods. Survival Rate. Treatment Outcome. Young Adult

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  • (PMID = 19360365.001).
  • [ISSN] 1432-2218
  • [Journal-full-title] Surgical endoscopy
  • [ISO-abbreviation] Surg Endosc
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] Germany
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11. Yoshida T, Matsumoto T, Morii Y, Aramaki M, Matsumoto S, Mori H, Kitano S: Implications of arterial anatomy in patients with cancer of the periampullary region. Hepatogastroenterology; 2005 Jan-Feb;52(61):8-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • METHODOLOGY: Between 1994 and 1998, 49 patients with periampullary cancer (31 distal bile duct and 18 ampullary tumors) underwent visceral angiography and radical pancreatoduodenectomy with lymphadenectomy.
  • Histopathologic diagnosis, tumor staging, morbidity, and mortality did not differ between the 2 groups.
  • [MeSH-major] Ampulla of Vater / radiography. Celiac Artery / radiography. Common Bile Duct Neoplasms / radiography. Hepatic Artery / radiography

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  • (PMID = 15782982.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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12. Terada T: Primary Pure Squamous Cell Carcinoma of the Duodenum: A Case Report. Gastroenterology Res; 2010 Feb;3(1):39-40
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • An endoscopic examination revealed a duodenal tumor.
  • The tumor was circumferential elevated one with duodenal obstruction, and located in the descending part near and distal to the ampulla of Vater.
  • Imaging modalities also detected the duodenal tumor, but did not show tumors of other locations including the pancreas.
  • The duodenal tumor was different from ampullary tumor and pancreatic tumor.
  • Six biopsies were obtained from the duodenal tumor.

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  • (PMID = 27956983.001).
  • [ISSN] 1918-2805
  • [Journal-full-title] Gastroenterology research
  • [ISO-abbreviation] Gastroenterology Res
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Canada
  • [Keywords] NOTNLM ; Duodenum / Histopathology / Squamous cell carcinoma
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13. Wagner PL, Chen YT, Yantiss RK: Immunohistochemical and molecular features of sporadic and FAP-associated duodenal adenomas of the ampullary and nonampullary mucosa. Am J Surg Pathol; 2008 Sep;32(9):1388-95
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  • [Title] Immunohistochemical and molecular features of sporadic and FAP-associated duodenal adenomas of the ampullary and nonampullary mucosa.
  • Much of the literature pertains to ampullary adenomas and those associated with familial adenomatous polyposis (FAP).
  • In this study, we evaluated the molecular features of a series of sporadic duodenal adenomas (n=22) that developed distal to the ampulla, and compared them with the features of sporadic ampullary adenomas (n=9) and FAP-related polyps (n=12).
  • Wnt signaling pathway abnormalities occurred in sporadic, nonampullary (82%), and ampullary (77%) adenomas at comparable rates, usually reflecting nuclear beta-catenin immunostaining (64% and 44%, respectively), and APC rather than beta-catenin, mutations.
  • KRAS mutations were infrequent in sporadic, nonampullary adenomas (18%), and FAP-related adenomas (9%); moderately frequent in ampullary adenomas (44%); and none of the cases harbored BRAF mutations.
  • [MeSH-minor] Aged. Aged, 80 and over. DNA Repair / physiology. Female. Humans. Immunohistochemistry. Intestinal Mucosa / pathology. MAP Kinase Signaling System / physiology. Male. Middle Aged. Polymerase Chain Reaction. Signal Transduction / physiology. Tumor Suppressor Protein p53 / metabolism. Wnt Proteins / metabolism


14. Ishii Y, Takahashi M, Yoshida S, Suzuki K: [A case of hepatic metastases of ampullary carcinoma which completely responded to intrahepatic infusion of 5-FU with low-dose l-leucovorin]. Gan To Kagaku Ryoho; 2005 Aug;32(8):1175-7
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  • [Title] [A case of hepatic metastases of ampullary carcinoma which completely responded to intrahepatic infusion of 5-FU with low-dose l-leucovorin].
  • A 70-year-old man was admitted with an ampullary carcinoma with multiple hepatic metastases.
  • The patient underwent a pancreaticoduodenectomy for control of bleeding from the tumor.
  • [MeSH-major] Ampulla of Vater. Duodenal Neoplasms / pathology. Fluorouracil / administration & dosage. Leucovorin / administration & dosage. Liver Neoplasms / drug therapy. Liver Neoplasms / secondary

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  • (PMID = 16121924.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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15. Cortes A, Sauvanet A, Bert F, Janny S, Sockeel P, Kianmanesh R, Ponsot P, Ruszniewski P, Belghiti J: Effect of bile contamination on immediate outcomes after pancreaticoduodenectomy for tumor. J Am Coll Surg; 2006 Jan;202(1):93-9
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  • [Title] Effect of bile contamination on immediate outcomes after pancreaticoduodenectomy for tumor.
  • STUDY DESIGN: Seventy-nine consecutive patients underwent PD for periampullary tumor with routine bile culture and antibiotic prophylaxis with cefazolin.
  • RESULTS: The distribution of tumors was comparable except for ampullary carcinoma, which was more frequent in group B+ patients (p = 0.001).
  • During PD for ampullary carcinoma or after interventional biliary endoscopy, a specific antibioprophylaxis should be evaluated.
  • [MeSH-major] Ampulla of Vater. Bile / microbiology. Common Bile Duct Neoplasms / surgery. Pancreaticoduodenectomy. Postoperative Complications

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  • (PMID = 16377502.001).
  • [ISSN] 1072-7515
  • [Journal-full-title] Journal of the American College of Surgeons
  • [ISO-abbreviation] J. Am. Coll. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Jurisić D, Doko M, Glavan E, Rosko D, Vidović D, Tomić K: Local recurrence of primary non-ampullary adenocarcinoma of duodenum after surgical treatment--a case report and a literature review. Coll Antropol; 2006 Mar;30(1):225-9
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  • [Title] Local recurrence of primary non-ampullary adenocarcinoma of duodenum after surgical treatment--a case report and a literature review.
  • Worldwide there is no general attitude on optimal surgical procedure in treatment of primary non-ampullary adenocarcinoma of duodenum, especially for early stage of duodenal cancer.
  • Some authors prefer local excision and segmental resection while others rather perform duodenopancreatic resection, even in the case of early stage of duodenal cancer with aim to avoid tumor recurrence.
  • According to our findings and literature review we gave some direction concerning the optimal diagnostic and surgical procedure for this rare tumor.
  • [MeSH-major] Duodenal Neoplasms / surgery. Neoplasm Recurrence, Local / surgery

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  • (PMID = 16617602.001).
  • [ISSN] 0350-6134
  • [Journal-full-title] Collegium antropologicum
  • [ISO-abbreviation] Coll Antropol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Croatia
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17. Tien YW, Yeh CC, Wang SP, Hu RH, Lee PH: Is blind pancreaticoduodenectomy justified for patients with ampullary neoplasms? J Gastrointest Surg; 2009 Sep;13(9):1666-73
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  • [Title] Is blind pancreaticoduodenectomy justified for patients with ampullary neoplasms?
  • Our aim in this study was to determine whether blind-PD is also justified for ampullary neoplasms.
  • METHODS: We retrospectively reviewed the records of all patients with presumed resectable ampullary neoplasms treated at the National Taiwan University Hospital from 1998 to 2008.
  • RESULTS: Of the 84 patients without a preoperative tissue diagnosis of malignance, 64 had blind-PD and 20 had ampullectomy (AMP) with intraoperative frozen section.
  • Patients with jaundice, gastrointestinal bleeding, imaging findings showing tumor invasion, and larger tumor size were significantly more frequently treated by blind-PD.
  • Final pathological diagnosis was benign in ten of 64 blind-PD-treated patients.
  • CONCLUSIONS: Our data support a selective use of blind-PD because (1) a significant portion (65%) of benign ampullary neoplasms can be safely and effectively treated by AMP, (2) blind-PD does not treat ampullary cancer at earlier stage, and (3) blind-PD is associated with significantly more complications and significantly longer hospital stay than AMP.
  • However, blind-PD is strongly recommended for patients with large ampullary neoplasms (>3 cm in diameter), with jaundice, or with malignant endoscopic appearance.
  • [MeSH-major] Ampulla of Vater / pathology. Pancreatic Neoplasms / pathology. Pancreatic Neoplasms / surgery. Pancreaticoduodenectomy / methods
  • [MeSH-minor] Aged. Biopsy, Needle. Cholangiopancreatography, Endoscopic Retrograde / methods. Cohort Studies. Disease-Free Survival. Female. Follow-Up Studies. Hospital Mortality / trends. Humans. Immunohistochemistry. Male. Middle Aged. Neoplasm Invasiveness / pathology. Neoplasm Staging. Postoperative Complications / mortality. Preoperative Care. Probability. Registries. Retrospective Studies. Risk Assessment. Sphincterotomy, Endoscopic. Statistics, Nonparametric. Survival Rate

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  • (PMID = 19557483.001).
  • [ISSN] 1873-4626
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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18. Frampton AE, Bong JJ, Kyriakides C, Cohen P, Jiao LR: En bloc resection of the pancreatic head and second part of duodenum for a duodenal gastrointestinal stromal tumor: a multi-media report. JOP; 2010;11(4):396-400
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  • [Title] En bloc resection of the pancreatic head and second part of duodenum for a duodenal gastrointestinal stromal tumor: a multi-media report.
  • A case of a 37-year-old female presenting with a one-year history of right upper quadrant pain is described here, who was subsequently found to have a mass in the head of the pancreas.
  • Computed tomography scans showed a 2 cm hypervascular lesion lying between the head of pancreas and the second part of the duodenum, suggestive of a neuroendocrine tumor, and confirmed by endoscopic ultrasound scan.
  • Histopathological and immunohistochemical analysis revealed the tumor to be peri-ampullary duodenal gastrointestinal stromal tumor not invading the pancreas.
  • Duodenal gastrointestinal stromal tumor can have a wide spectrum of clinical presentation.
  • The accurate diagnosis of duodenal gastrointestinal stromal tumor is essential for determining the appropriate surgical intervention.
  • [MeSH-minor] Adult. Duodenum / pathology. Duodenum / radiography. Duodenum / surgery. Female. Humans. Pancreas / pathology. Pancreas / radiography. Pancreas / surgery. Tomography, X-Ray Computed

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  • (PMID = 20601819.001).
  • [ISSN] 1590-8577
  • [Journal-full-title] JOP : Journal of the pancreas
  • [ISO-abbreviation] JOP
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
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19. Matsubayashi H, Matsunaga K, Sasaki K, Yamaguchi Y, Hasuike N, Ono H: Small carcinoid tumor of papilla of the Vater with lymph node metastases. J Gastrointest Cancer; 2008;39(1-4):61-5
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  • [Title] Small carcinoid tumor of papilla of the Vater with lymph node metastases.
  • INTRODUCTION: Carcinoid of papilla of the Vater is a rare entity.
  • Detailed prognostic factors of this tumor have not yet been elucidated, and treatment choices include local resection and pancreatoduodenectomy with excision of lymph nodes.
  • CASE REPORT: A 59-year-old woman, who was diagnosed with liver dysfunction and underwent a cholecystectomy, was referred to our institution with a suspected ampullary tumor.
  • Computed tomography showed 1 cm of enhancement at the duodenal ampulla, but no visible lymph adenopathy.
  • In the duodenoscopic view, her papilla was slightly enlarged without orifice, so that forceps biopsy was performed from the common ampullary channel after needle-knife incision.
  • Tissue obtained by biopsy revealed a possible carcinoid tumor, with 1.1% of Ki-67 labeling index.
  • Pancreatoduodenectomy was performed, and the resected specimen showed a carcinoid tumor of the ampulla, 1.2 cm in diameter, with metastases to regional lymph nodes and a 4% Ki-67 labeling index.
  • It is suggested that despite the small size and low proliferation index, an ampullary carcinoid may not be cured by local resection.
  • [MeSH-major] Ampulla of Vater. Carcinoid Tumor / pathology. Common Bile Duct Neoplasms / pathology

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  • (PMID = 19234807.001).
  • [ISSN] 1941-6628
  • [Journal-full-title] Journal of gastrointestinal cancer
  • [ISO-abbreviation] J Gastrointest Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Ki-67 Antigen
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21. Woo SM, Ryu JK, Lee SH, Lee WJ, Hwang JH, Yoo JW, Park JK, Kang GH, Kim YT, Yoon YB: Feasibility of endoscopic papillectomy in early stage ampulla of Vater cancer. J Gastroenterol Hepatol; 2009 Jan;24(1):120-4
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  • [Title] Feasibility of endoscopic papillectomy in early stage ampulla of Vater cancer.
  • BACKGROUND AND AIM: Although endoscopic papillectomy has been attempted in early stage ampullary cancer (pTis, T1), its curative role and indications remain uncertain.
  • METHODS: We performed a retrospective analysis of clinical and histopathological data of 216 patients with ampullary cancer between 1991 and 2006.
  • RESULTS: No tumor in pTis stage had metastasized to lymph nodes and only 9% of tumors in pT1 had metastasized.
  • Tumor size (P = 0.018), depth of invasion (P = 0.021) and venous invasion (P = 0.014) were found to be significantly related to lymph node metastasis.
  • Cases with early stage ampullary cancer of less than 2 cm with a well-differentiated histology and no angiolymphatic invasion (n = 13) showed no lymph node metastasis and no recurrence during a median follow up of 35.9 months.
  • CONCLUSION: Endoscopic papillectomy can be adopted as a viable alternative to surgery in patients with early stage ampullary cancer of less than 2 cm in size and with a well-differentiated histology.
  • [MeSH-major] Ampulla of Vater / surgery. Common Bile Duct Neoplasms / surgery. Endoscopy, Digestive System
  • [MeSH-minor] Cell Differentiation. Feasibility Studies. Humans. Kaplan-Meier Estimate. Lymphatic Metastasis. Neoplasm Invasiveness. Neoplasm Staging. Patient Selection. Proportional Hazards Models. Recurrence. Retrospective Studies. Risk Assessment. Time Factors. Treatment Outcome

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  • (PMID = 19032444.001).
  • [ISSN] 1440-1746
  • [Journal-full-title] Journal of gastroenterology and hepatology
  • [ISO-abbreviation] J. Gastroenterol. Hepatol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Australia
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22. Djurić-Stefanović A, Masulović D, Saranović Dj, Ivanović A, Stević R, Kostić J, Randić K, Mladenović M: [Computerized tomography in postoperative monitoring of patients with the Whipple operation--characteristics of CT findings]. Acta Chir Iugosl; 2009;56(4):107-11
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  • We presented the postoperative CT findings of patients after the Whipple's operation (cephalic pancreaticoduodenectomy), performed for the pancreatic head cancer, or ampullary carcinoma.
  • In addition, difficulties in differentiation of afferent jejunal loop from the recurrent tumor by CT are discussed, and references from the literature about the possibilities of successful visualization of the afferent jejunal loop are cited.
  • Possible locations and CT appearances of the tumor recurrences are presented.
  • [MeSH-minor] Humans. Neoplasm Recurrence, Local / radiography. Postoperative Complications / radiography

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  • (PMID = 20420005.001).
  • [ISSN] 0354-950X
  • [Journal-full-title] Acta chirurgica Iugoslavica
  • [ISO-abbreviation] Acta Chir Iugosl
  • [Language] srp
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Serbia
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23. Cho EY, Kim TH, Park SD, Yun KJ, Choi SC, Kim HC, Nah YH: Acral metastasis in a patient with ampullary carcinoma. Korean J Intern Med; 2007 Mar;22(1):55-8
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  • [Title] Acral metastasis in a patient with ampullary carcinoma.
  • Although skin metastasis from a malignant tumor of an internal organ usually occurs at an advanced disease stage, there has been no prior report of a cutaneous acral metastasis from ampullary carcinoma to date.
  • We report a 71-year old male patient with cutaneous metastasis from an ampullary adenocarcinoma.
  • The patient had a history of pylorus preserving pancreaticoduodenectomy for carcinoma of the ampulla of Vater two years prior to presentation.
  • This case illustrates that cutaneous metastasis from ampullary carcinoma has a poor prognosis.
  • [MeSH-major] Adenocarcinoma / pathology. Ampulla of Vater / pathology. Common Bile Duct Neoplasms / pathology. Skin Neoplasms / secondary

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  • (PMID = 17427649.001).
  • [ISSN] 1226-3303
  • [Journal-full-title] The Korean journal of internal medicine
  • [ISO-abbreviation] Korean J. Intern. Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2687605
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24. Kim YK, Han YM, Kim CS: Usefulness of fat-suppressed T1-weighted MRI using orally administered superparamagnetic iron oxide for revealing ampullary carcinomas. J Comput Assist Tomogr; 2007 Jul-Aug;31(4):519-25
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  • [Title] Usefulness of fat-suppressed T1-weighted MRI using orally administered superparamagnetic iron oxide for revealing ampullary carcinomas.
  • OBJECTIVE: To evaluate the value of adding fat-suppressed (FS) T1-weighted magnetic resonance imaging (MRI) with orally administered superparamagnetic iron oxide (SPIO) to the 3-dimensional dynamic MRI for revealing ampullary carcinomas.
  • MATERIALS: Twenty-five patients with ampullary carcinoma who underwent MRI with orally administered SPIO, including a FS T1-weighted fast low-angle shot (FLASH) sequence, a respiratory-triggered turbo spin-echo (RT-TSE) sequence, and the 3-phasic 3-dimensional dynamic images, were enrolled in this study.
  • The images were compared quantitatively by measuring the tumor-pancreas (duodenum) contrast-to-noise ratio and, qualitatively, by evaluating tumor conspicuity.
  • RESULTS: For the tumor-pancreas (duodenum) contrast-to-noise ratio, the FLASH was significantly higher than those of the dynamic set and RT-TSE (P < 0.05).
  • The tumor conspicuity with the combination of the dynamic set and the FLASH was also significantly better than those of the dynamic set, and the combination of the dynamic set and RT-TSE (P = 0.001).
  • CONCLUSIONS: Addition of the FS FLASH image using orally administered SPIO to the dynamic MRI is useful for revealing ampullary carcinoma.
  • [MeSH-major] Adenocarcinoma / diagnosis. Ampulla of Vater. Common Bile Duct Neoplasms / diagnosis. Contrast Media. Ferric Compounds. Image Enhancement / methods. Magnetic Resonance Imaging / methods

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  • (PMID = 17882025.001).
  • [ISSN] 0363-8715
  • [Journal-full-title] Journal of computer assisted tomography
  • [ISO-abbreviation] J Comput Assist Tomogr
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Contrast Media; 0 / Ferric Compounds; 1K09F3G675 / ferric oxide
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25. Aloysius MM, Hewavisenthi SJ, Bates TE, Rowlands BJ, Lobo DN, Zaitoun AM: Predictive value of tumor proliferative indices in periampullary cancers: Ki-67, mitotic activity index (MI) and volume corrected mitotic index (M/V) using tissue microarrays. World J Surg; 2010 Sep;34(9):2115-21
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  • [Title] Predictive value of tumor proliferative indices in periampullary cancers: Ki-67, mitotic activity index (MI) and volume corrected mitotic index (M/V) using tissue microarrays.
  • Expression of Ki-67 was assessed as the percentage of cancer cell nuclei expressing MIB1, MI as the mean percentage of Ki-67 from 10 random high-power fields, and M/V was calculated after standardizing MI for connective tissue volume and microscope parameters in the tumor using established protocols.
  • There was no statistically significant difference in survival, based on M/V score, for tumors of the intestinal subtype (ampullary and duodenal adenocarcinoma).
  • CONCLUSIONS: In periampullary cancers, Ki-67 and MI are proliferative indices predictive of tumor behavior.
  • [MeSH-major] Ampulla of Vater. Bile Duct Neoplasms / metabolism. Bile Ducts, Intrahepatic. Carcinoma, Pancreatic Ductal / metabolism. Cholangiocarcinoma / metabolism. Common Bile Duct Neoplasms / metabolism. Duodenal Neoplasms / metabolism. Ki-67 Antigen / analysis. Mitotic Index. Pancreatic Neoplasms / metabolism
  • [MeSH-minor] Humans. Immunohistochemistry. Lymphatic Metastasis. Microarray Analysis. Neoplasm Invasiveness

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  • (PMID = 20556608.001).
  • [ISSN] 1432-2323
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Ki-67 Antigen
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26. Gilani N, Ramirez FC: Endoscopic resection of an ampullary carcinoid presenting with upper gastrointestinal bleeding: a case report and review of the literature. World J Gastroenterol; 2007 Feb 28;13(8):1268-70
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  • [Title] Endoscopic resection of an ampullary carcinoid presenting with upper gastrointestinal bleeding: a case report and review of the literature.
  • Ampullary carcinoid is a rare tumor that can present with gastrointestinal bleeding, obstructive jaundice or pancreatitis.
  • We report a very rare case of a non-metastatic ampullary carcinoid causing upper gastrointestinal bleeding, which was managed by endoscopic ampullectomy.
  • [MeSH-major] Ampulla of Vater / surgery. Carcinoid Tumor / surgery. Common Bile Duct Neoplasms / surgery. Gastrointestinal Hemorrhage / etiology

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  • (PMID = 17451212.001).
  • [ISSN] 1007-9327
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] China
  • [Number-of-references] 11
  • [Other-IDs] NLM/ PMC4147006
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27. Santini D, Vincenzi B, Fratto ME, Perrone G, Lai R, Catalano V, Cass C, Ruffini PA, Spoto C, Muretto P, Rizzo S, Muda AO, Mackey JR, Russo A, Tonini G, Graziano F: Prognostic role of human equilibrative transporter 1 (hENT1) in patients with resected gastric cancer. J Cell Physiol; 2010 May;223(2):384-8
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  • The hENT1 expression has been demonstrated to be related with prognosis and activity of gemcitabine-based therapy in breast, ampullary, lung, and pancreatic cancer.
  • We investigated the immunohistochemical expression of hENT in tumor samples from 111 patients with resected gastric adenocarcinoma, correlating these data with clinical parameters and disease outcomes.
  • [MeSH-major] Adenocarcinoma / diagnosis. Adenocarcinoma / metabolism. Biomarkers, Tumor / metabolism. Equilibrative Nucleoside Transporter 1 / metabolism. Gastric Mucosa / metabolism. Stomach Neoplasms / diagnosis. Stomach Neoplasms / metabolism
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Agents / metabolism. Antineoplastic Agents / pharmacokinetics. Cohort Studies. Disease Progression. Disease-Free Survival. Drug Resistance, Neoplasm / physiology. Female. Humans. Immunohistochemistry. Male. Middle Aged. Neoplasm Metastasis / physiopathology. Neoplasm Recurrence, Local / diagnosis. Neoplasm Recurrence, Local / prevention & control. Predictive Value of Tests. Prognosis. Retrospective Studies. Survival Rate

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  • (PMID = 20082300.001).
  • [ISSN] 1097-4652
  • [Journal-full-title] Journal of cellular physiology
  • [ISO-abbreviation] J. Cell. Physiol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / Equilibrative Nucleoside Transporter 1; 0 / SLC29A1 protein, human
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28. Jaoude WA, Lau C, Sugiyama G, Duncan A: Management of ampullary carcinoid tumors with pancreaticoduodenectomy. J Surg Case Rep; 2010;2010(8):4
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  • [Title] Management of ampullary carcinoid tumors with pancreaticoduodenectomy.
  • A 66 year old female was found to have an ampullary mass on endoscopic examination.
  • A pancreaticoduodenectomy was performed and the pathology was consistent with carcinoid tumor.
  • Carcinoid tumors of the ampulla of Vater are rare tumors of the gastrointestinal tract, accounting for 0.3-1% of gastrointestinal carcinoids.
  • Management of ampullary carcinoid tumor with pancreaticoduodenectomy is in accordance with current recommendations.

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  • [Copyright] © JSCR.
  • (PMID = 24946347.001).
  • [ISSN] 2042-8812
  • [Journal-full-title] Journal of surgical case reports
  • [ISO-abbreviation] J Surg Case Rep
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC3649155
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29. Hosaka A, Nagayoshi M, Sugizaki K, Masaki Y: Gallbladder perforation associated with carcinoma of the duodenal papilla: a case report. World J Surg Oncol; 2010;8:41
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  • A tumor of the ampulla of Vater causes gradually progressive symptoms, and is rarely associated with perforation of the gallbladder.
  • CASE PRESENTATION: A 56-year-old man with carcinoma of the ampulla of Vater presented with spontaneous gallbladder perforation and localized bile peritonitis.
  • Postoperative upper gastrointestinal endoscopy demonstrated a slightly enlarged duodenal papilla, and biopsy revealed adenocarcinoma of the ampulla.
  • CONCLUSION: Ampullary carcinoma can be associated with gallbladder perforation and present with acute manifestations.
  • [MeSH-major] Adenocarcinoma / pathology. Ampulla of Vater / pathology. Common Bile Duct Neoplasms / pathology. Gallbladder / pathology. Gallbladder Diseases / diagnosis
  • [MeSH-minor] Abdominal Pain. Humans. Male. Middle Aged. Pancreaticoduodenectomy. Peritonitis / diagnosis. Rupture, Spontaneous. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 20487525.001).
  • [ISSN] 1477-7819
  • [Journal-full-title] World journal of surgical oncology
  • [ISO-abbreviation] World J Surg Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
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30. Cao D, Humphrey PA, Allan RW: SALL4 is a novel sensitive and specific marker for metastatic germ cell tumors, with particular utility in detection of metastatic yolk sac tumors. Cancer; 2009 Jun 15;115(12):2640-51
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  • BACKGROUND: The correct diagnosis of metastatic germ cell tumors is critical, because these tumors can be effectively treated and are even cured with modern therapy.
  • Their histopathologic diagnosis can be challenging without immunohistochemical markers, which currently have limitations.
  • In addition, 170 metastatic nongerm cell malignancies, including 158 carcinomas (6 head and neck, 8 thyroid, 12 lung, 8 breast, 7 hepatocellular, 3 cholangiocarcinomas, 2 ampullary, 10 pancreatic, 18 gastric, 15 esophageal, 10 renal cell, 10 urothelial, 12 prostatic, 18 ovarian, 6 uterine, and 13 colonic) and 12 melanomas, were also stained to test SALL4 specificity.
  • RESULTS: All 22 seminomas, 7 dysgerminomas, 22 embryonal carcinomas, and 14 of 15 yolk sac tumors displayed strong and diffuse SALL positivity in >90% of tumor cells (80% of tumor cells were strongly positive in the remaining yolk sac tumor).
  • In contrast, only 10 (esophageal, gastric, and colonic adenocarcinomas) of 170 metastatic somatic tumors demonstrated focally weak SALL4 reactivity (<25% tumor cells).
  • [MeSH-major] Biomarkers, Tumor / analysis. Neoplasm Metastasis / diagnosis. Neoplasms, Germ Cell and Embryonal / diagnosis. Ovarian Neoplasms / diagnosis. Testicular Neoplasms / diagnosis. Transcription Factors / analysis
  • [MeSH-minor] Endodermal Sinus Tumor / diagnosis. Endodermal Sinus Tumor / pathology. Female. Humans. Immunohistochemistry. Male. Octamer Transcription Factor-3 / analysis

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  • [Copyright] (c) 2009 American Cancer Society.
  • (PMID = 19365862.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Octamer Transcription Factor-3; 0 / POU5F1 protein, human; 0 / SALL4 protein, human; 0 / Transcription Factors
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31. Nikfarjam M, Gusani NJ, Kimchi ET, Mahraj RP, Staveley-O'Carroll KF: Combined right nephrectomy and pancreaticoduodenectomy. Indications and outcomes. JOP; 2008;9(4):449-55
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  • RESULTS: Three patients had retroperitoneal sarcomas adherent to the right kidney and duodenum, one patient had a locally advanced transitional-cell carcinoma and the remaining patient presented with an ampullary malignancy and concurrent right renal tumor All patients underwent en bloc resection with clear margins.

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  • (PMID = 18648136.001).
  • [ISSN] 1590-8577
  • [Journal-full-title] JOP : Journal of the pancreas
  • [ISO-abbreviation] JOP
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
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32. Ohike N, Coban I, Kim GE, Basturk O, Tajiri T, Krasinskas A, Bandyopadhyay S, Morohoshi T, Shimada Y, Kooby DA, Staley CA, Goodman M, Adsay NV: Tumor budding as a strong prognostic indicator in invasive ampullary adenocarcinomas. Am J Surg Pathol; 2010 Oct;34(10):1417-24
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  • [Title] Tumor budding as a strong prognostic indicator in invasive ampullary adenocarcinomas.
  • Prognostication of invasive ampullary adenocarcinomas (AACs) and their stratification into appropriate management categories have been highly challenging owing to a lack of well-established predictive parameters.
  • In colorectal cancers, recent studies have shown that tumor budding confers a worse prognosis and correlates significantly with nodal metastasis and recurrence; however, this has not been evaluated in AAC.To investigate the prevalence, significance, and clinical correlations of tumor budding in AAC, 244 surgically resected, stringently defined, invasive AAC were analyzed for tumor budding---defined as the presence of more than or equal to 5 isolated single cancer cells or clusters composed of fewer than 5 cancer cells per field measuring 0.785 mm using a 20× objective lens in the stroma of the invasive front.
  • Furthermore, using a multivariable Cox regression model, tumor budding was found to be an independent predictor of survival (P=0.01), which impacts prognosis (hazard ratio: 2.6) even more than T-stage and lymph node metastasis (hazard ratio: 1.9 and 1.8, respectively).In conclusion, tumor budding is frequently encountered in AAC.

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  • [ErratumIn] Am J Surg Pathol. 2010 Dec;34(12):1892. Volkan Adsay, Nazmi [corrected to Adsay, N. Volkan]
  • (PMID = 20871215.001).
  • [ISSN] 1532-0979
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P50 CA062924; United States / NCI NIH HHS / CA / CA088273-01; United States / NCI NIH HHS / CA / P50 CA062924-18; United States / NCI NIH HHS / CA / P20 CA101936; United States / NCI NIH HHS / CA / R03 CA088273; United States / NCI NIH HHS / CA / CA101936; United States / NCI NIH HHS / CA / R03 CA088273-01
  • [Publication-type] Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Other-IDs] NLM/ NIHMS315768; NLM/ PMC3163902
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33. Hopf S, Buchalla R, Scheil F, Heusermann U, Börm W: Skull metastasis of ampulla of Vater adenocarcinoma 5 years after Whipple operation: case report and literature review. J Neurooncol; 2009 Oct;95(1):141-145
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  • [Title] Skull metastasis of ampulla of Vater adenocarcinoma 5 years after Whipple operation: case report and literature review.
  • Skull metastases can occur with nearly all types of tumor.
  • Carcinoma of the ampulla of Vater is an uncommon tumor accounting for approximately 0.2% of all gastrointestinal malignancies, with an estimated incidence of less than 6 cases per 1,000,000 population per year.
  • We report about an extremely rare case of a 54-year-old female patient with a right frontal skull metastases of an ampulla of Vater adenocarcinoma 5 years after pylorus-preserving pancreaticoduodenectomy.
  • Literature review revealed only one published case of cranial bone metastases of carcinoma of the ampulla of Vater.
  • To the best of our knowledge this is the first case report of skull metastases of ampullary adenocarcinoma after a symptom-free interval of 5 years after R0 resection of the primary tumor, and the second published case that involves the skull.
  • [MeSH-major] Adenocarcinoma / etiology. Adenocarcinoma / pathology. Ampulla of Vater / pathology. Skull Neoplasms / secondary. Whipple Disease / surgery

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  • (PMID = 19444594.001).
  • [ISSN] 1573-7373
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 15
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34. Morla D, Alazemi S, Lichtstein D: Stauffer's syndrome variant with cholestatic jaundice: a case report. J Gen Intern Med; 2006 Jul;21(7):C11-3
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  • Cholestasis is a common feature of several malignant diseases, including pancreatic, hepatic, gallbladder, and ampullary carcinomas.
  • Jaundice and liver dysfunction resolved completely after surgical resection of the tumor.
  • This case illustrates the protean manifestations of RCC, and the importance of considering Stauffer's syndrome and its variant in the differential diagnosis of anicteric and icteric cholestasis, which may allow early recognition and treatment of an underlying malignancy.
  • [MeSH-major] Carcinoma, Renal Cell / diagnosis. Jaundice, Obstructive / etiology. Kidney Neoplasms / diagnosis. Paraneoplastic Syndromes / etiology

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  • (PMID = 16808761.001).
  • [ISSN] 1525-1497
  • [Journal-full-title] Journal of general internal medicine
  • [ISO-abbreviation] J Gen Intern Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC1924715
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35. Hsu SD, Chan DC, Hsieh HF, Chen TW, Yu JC, Chou SJ: Ectopic pancreas presenting as ampulla of Vater tumor. Am J Surg; 2008 Apr;195(4):498-500
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  • [Title] Ectopic pancreas presenting as ampulla of Vater tumor.
  • Ectopic pancreas is relatively rare and is defined as pancreatic tissue that is situated abnormally, has no contact with the normal pancreas, and has its own ductal system and blood supply.
  • Most patients with an ectopic pancreas are asymptomatic, and, if present, symptoms are nonspecific and depend on the site of the lesion and the different complications encountered.
  • Herein, we report a patient presenting with symptoms of ampullary tumor with obstructive jaundice, but the imaging study did not suggest the possibility of ectopic pancreas preoperatively.
  • [MeSH-major] Ampulla of Vater. Choristoma / diagnosis. Common Bile Duct Diseases / diagnosis. Pancreas
  • [MeSH-minor] Cholangiopancreatography, Endoscopic Retrograde. Common Bile Duct Neoplasms / diagnosis. Diagnosis, Differential. Humans. Male. Middle Aged. Tomography, X-Ray Computed

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  • (PMID = 18304504.001).
  • [ISSN] 1879-1883
  • [Journal-full-title] American journal of surgery
  • [ISO-abbreviation] Am. J. Surg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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36. Higashi M, Goto M, Saitou M, Shimizu T, Rousseau K, Batra SK, Yonezawa S: Immunohistochemical study of mucin expression in periampullary adenomyoma. J Hepatobiliary Pancreat Sci; 2010 May;17(3):275-83
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  • BACKGROUND/PURPOSE: Benign tumors and tumor-like conditions in the ampullary area are uncommon, and there are extremely rare cases of adenomyoma (AM) and adenomyomatous hyperplasia (AMH).
  • In addition, the differential diagnosis of AM and AMH from carcinoma is often difficult by standard endoscopic biopsy and cytopathological analysis that may show differential findings, resulting in unnecessary surgeries sometimes being performed.
  • The EGCs showed no expression of MUC1 or MUC4, both of which were identified as malignant tumor markers in our previous series of mucin expression studies in pancreatobiliary tumors.
  • CONCLUSIONS: A combined evaluation of IHC findings may be effective in the detection of AM and AMH, and also in distinguishing benign periampullary lesions, such as AM and AMH, from ampulla of Vater adenocarcinoma, thus avoiding excessive surgery.

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  • (PMID = 19784541.001).
  • [ISSN] 1868-6982
  • [Journal-full-title] Journal of hepato-biliary-pancreatic sciences
  • [ISO-abbreviation] J Hepatobiliary Pancreat Sci
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R01 CA078590; United States / NCI NIH HHS / CA / CA 78590
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / MUC4 protein, human; 0 / MUC5AC protein, human; 0 / MUC6 protein, human; 0 / Mucin 5AC; 0 / Mucin-4; 0 / Mucin-6; 0 / Mucins
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37. Hwang S, Moon KM, Park JI, Kim MH, Lee SG: Retroduodenal resection of ampullary carcinoid tumor in a patient with cavernous transformation of the portal vein. J Gastrointest Surg; 2007 Oct;11(10):1322-7
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  • [Title] Retroduodenal resection of ampullary carcinoid tumor in a patient with cavernous transformation of the portal vein.
  • Although pancreatoduodenectomy is the standard treatment for periampullary neoplasms, limited pancreas-preserving resections are sometimes performed.
  • This report describes a carcinoid tumor of the ampulla of Vater for which pancreatoduodenectomy was not feasible because of diffuse cavernous transformation of the portal vein (PV) secondary to main PV obliteration of unknown cause.
  • We performed retroduodenal resection of the ampullary carcinoid with total preservation of the pancreas.
  • The patient recovered uneventfully and is currently progressing well at 10 months postoperatively, with no tumor recurrence or complications.
  • [MeSH-major] Ampulla of Vater. Carcinoid Tumor / surgery. Common Bile Duct Neoplasms / surgery. Digestive System Surgical Procedures / methods

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  • (PMID = 17674113.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 20
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38. Vorob'ev GI, Shelygin IuA, Pikunov DIu, Rybakov EG, Dzhanaev IuA, Fomenko OIu: [Proctectomy with external sphincter preservation: long-term functional results]. Khirurgiia (Mosk); 2009;(10):4-9
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  • 52 patients with the lower ampullary rectal cancer with tumor localization on the dentate line level had been operated with the use of the originally developed reconstructive technique, permitting preservation of the external anal sphincter elements and, consequently, partial continence.

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  • (PMID = 20032928.001).
  • [ISSN] 0023-1207
  • [Journal-full-title] Khirurgiia
  • [ISO-abbreviation] Khirurgiia (Mosk)
  • [Language] rus
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] Russia (Federation)
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39. Santini D, Baldi A, Vincenzi B, Mellone P, Campioni M, Antinori A, Borzomati D, Coppola R, Magistrelli P, Tonini G: Mucin 2 (MUC2) and mucin 5 (MUC5) expression is not associated with prognosis in patients with radically resected ampullary carcinoma. J Clin Pathol; 2007 Sep;60(9):1069-70
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  • [Title] Mucin 2 (MUC2) and mucin 5 (MUC5) expression is not associated with prognosis in patients with radically resected ampullary carcinoma.
  • [MeSH-major] Ampulla of Vater. Biomarkers, Tumor / metabolism. Common Bile Duct Neoplasms / metabolism. Mucins / metabolism
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Mucin-2. Mucin-5B. Neoplasm Proteins / metabolism. Prognosis. Survival Analysis

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  • (PMID = 17761747.001).
  • [ISSN] 0021-9746
  • [Journal-full-title] Journal of clinical pathology
  • [ISO-abbreviation] J. Clin. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / MUC2 protein, human; 0 / MUC5B protein, human; 0 / Mucin-2; 0 / Mucin-5B; 0 / Mucins; 0 / Neoplasm Proteins
  • [Other-IDs] NLM/ PMC1972431
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40. Carter JT, Grenert JP, Rubenstein L, Stewart L, Way LW: Neuroendocrine tumors of the ampulla of Vater: biological behavior and surgical management. Arch Surg; 2009 Jun;144(6):527-31
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  • [Title] Neuroendocrine tumors of the ampulla of Vater: biological behavior and surgical management.
  • OBJECTIVES: To describe the biological behavior and surgical management of ampullary neuroendocrine tumors in 7 patients.
  • PATIENTS: Seven patients with ampullary neuroendocrine tumors.
  • Even when the tumor expressed gastrin, vasoactive intestinal peptide, or somatostatin, no patient had a hypersecretion syndrome.
  • One patient with a high-grade malignant neoplasm died after 15 months.
  • Two patients had transduodenal local resections, one for a 1.1-cm paraganglioma (disease-free, 11 years) and the other for a 0.6-cm carcinoid tumor (disease-free, 7 months).
  • CONCLUSIONS: This is one of the largest series of neuroendocrine tumors of the ampulla.
  • Unlike duodenal carcinoid tumors, hypersecretion syndromes were absent and small tumor size did not preclude locoregional metastases.
  • Tumor grade predicted survival.
  • [MeSH-major] Ampulla of Vater. Common Bile Duct Neoplasms / pathology. Common Bile Duct Neoplasms / surgery. Neuroendocrine Tumors / pathology. Neuroendocrine Tumors / surgery

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  • (PMID = 19528385.001).
  • [ISSN] 1538-3644
  • [Journal-full-title] Archives of surgery (Chicago, Ill. : 1960)
  • [ISO-abbreviation] Arch Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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41. Mazziotta RM, Borczuk AC, Powell CA, Mansukhani M: CDX2 immunostaining as a gastrointestinal marker: expression in lung carcinomas is a potential pitfall. Appl Immunohistochem Mol Morphol; 2005 Mar;13(1):55-60
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  • Paraffin-embedded sections of various adenocarcinomas (13 colonic, 11 mucinous ovarian, 5 serous ovarian, 8 pancreatic, 6 ampullary, 12 gastric, 5 esophageal, 10 endometrial, 29 breast, and 55 lung) and 29 additional lung carcinomas (nonadenocarcinomas) were immunostained with antibodies to CDX2 protein, cytokeratin 7 (CK7), and cytokeratin 20 (CK20).
  • Esophageal, gastric, and ampullary adenocarcinomas showed variable immunoreactivity for CDX2.

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  • [CommentIn] Appl Immunohistochem Mol Morphol. 2006 Jun;14(2):249-50 [16785799.001]
  • (PMID = 15722794.001).
  • [ISSN] 1541-2016
  • [Journal-full-title] Applied immunohistochemistry & molecular morphology : AIMM
  • [ISO-abbreviation] Appl. Immunohistochem. Mol. Morphol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / CDX2 protein, human; 0 / Homeodomain Proteins; 0 / Intermediate Filament Proteins; 0 / KRT20 protein, human; 0 / KRT7 protein, human; 0 / Keratin-20; 0 / Keratin-7; 68238-35-7 / Keratins
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42. Ney JT, Zhou H, Sipos B, Büttner R, Chen X, Klöppel G, Gütgemann I: Podocalyxin-like protein 1 expression is useful to differentiate pancreatic ductal adenocarcinomas from adenocarcinomas of the biliary and gastrointestinal tracts. Hum Pathol; 2007 Feb;38(2):359-64
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  • Metastases of adenocarcinomas from the pancreas, liver, and gastrointestinal tract are difficult to distinguish from each other because of their similar morphological and immunohistochemical features.
  • When used as a differential diagnostic marker, ampullary carcinoma needs to be excluded, as 30% (6/20, P = .24) of ampullary carcinomas stain positive, especially those of the signet-ring type (3/3).
  • It is concluded that immunoreactivity for PODXL-1 favors a pancreatic origin if ampullary carcinoma is excluded.
  • [MeSH-minor] Biomarkers, Tumor / analysis. Biomarkers, Tumor / metabolism. Blotting, Western. Diagnosis, Differential. Female. Humans. Immunohistochemistry. Male

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  • (PMID = 17137615.001).
  • [ISSN] 0046-8177
  • [Journal-full-title] Human pathology
  • [ISO-abbreviation] Hum. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Sialoglycoproteins; 0 / podocalyxin
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43. Dai YC, Ho CL, Tsai YC, Hsu YH, Chang YC, Liu HS, Chen HH, Chow NH: Allelic loss of 14q32 in the pathogenesis of gastrointestinal and ampullary malignancies: mapping of the target region to a 17 cM interval. J Cancer Res Clin Oncol; 2005 Feb;131(2):94-100
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  • [Title] Allelic loss of 14q32 in the pathogenesis of gastrointestinal and ampullary malignancies: mapping of the target region to a 17 cM interval.
  • PURPOSE: The genetic basis for gastrointestinal and ampullary carcinomas remains uncertain.
  • METHODS: We screened the allelic status on 16 chromosomal arms in a patient with synchronous ampullary carcinoma and gastric cancer, but who had no family history of familial cancer syndrome.
  • The significance of the shared 14q deletion was examined on clinical cohorts of sporadic gastric (n=12) and ampullary (n=10) carcinoma, respectively.
  • RESULTS: The synchronous gastric and ampullary carcinomas had no frameshift mutations in the APC, MSH2, MSH3, and MSH6 genes.
  • The same allelic loss was also detected in one of ampullary carcinomas (10%) and two of gastric cancers (16.7%).
  • CONCLUSIONS: This study illustrates a paradigm using molecular genetic approach in identifying chromosome 14q32 that may harbor a tumor suppressor gene involved in the pathogenesis of a subset of gastrointestinal and ampullary malignancies.
  • [MeSH-major] Ampulla of Vater / pathology. Carcinoma / genetics. Chromosomes, Human, Pair 14 / genetics. Common Bile Duct Neoplasms / genetics. Genetic Predisposition to Disease. Loss of Heterozygosity / genetics. Stomach Neoplasms / genetics

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  • (PMID = 15503134.001).
  • [ISSN] 0171-5216
  • [Journal-full-title] Journal of cancer research and clinical oncology
  • [ISO-abbreviation] J. Cancer Res. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
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44. Lattarulo S, Ugenti I, Filograna MA, Pezzolla A, Ferrarese F, Fabiano G: [Extra-ampullary duodenal neoplasms]. Ann Ital Chir; 2007 Jan-Feb;78(1):21-5
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  • [Title] [Extra-ampullary duodenal neoplasms].
  • [Transliterated title] Le neoplasie duodenali in sede extra-ampollare.
  • The authors report on twelve cases of non-ampullary duodenal neoplasm and remark the rarity of this pathology.
  • According to the literature, the traditional endoscopy is the mainstay diagnostic test, because of aspecific digestive symptoms, but the authors stress the importance of the "longue" endoscopy or endoscopy integrated with duodenography in non-responders patients who had non-diagnostic traditional endoscopy for neoplasm.
  • Duodeno-cephalo-pancreatectomy and segmentary duodenal resection are proposed by tumor site.
  • Better results for prognosis can be obtained only with an early diagnosis and radical surgical therapy, because of chemotherapy and radiotherapy don't improve survival.
  • [MeSH-major] Adenocarcinoma / diagnosis. Adenocarcinoma / surgery. Duodenal Neoplasms / diagnosis. Duodenal Neoplasms / surgery. Endoscopy, Gastrointestinal

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  • (PMID = 17518326.001).
  • [ISSN] 0003-469X
  • [Journal-full-title] Annali italiani di chirurgia
  • [ISO-abbreviation] Ann Ital Chir
  • [Language] ita
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Italy
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45. Park S, Kim SW, Lee BL, Jung EJ, Kim WH: Expression of E-cadherin and beta-catenin in the adenoma-carcinoma sequence of ampulla of Vater cancer. Hepatogastroenterology; 2006 Jan-Feb;53(67):28-32
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  • [Title] Expression of E-cadherin and beta-catenin in the adenoma-carcinoma sequence of ampulla of Vater cancer.
  • BACKGROUND/AIMS: Ampullary carcinoma is uncommon but provides a good model for adenoma-carcinoma sequence.
  • During the adenoma-carcinoma transition, the tumor cells should acquire the ability to invade.
  • The E-cadherin-catenin complex connects the adjacent epithelial cells at the zona adherens, and this adhesion interferes with the tumor cell invasion.
  • METHODOLOGY: 111 cases of ampullary carcinoma were investigated with E-cadherin and beta-catenin expression with immunohistochemistry and the result was compared with their clinicopathologic and survival results.
  • RESULTS: Expressional loss of E-cadherin was detected in 3 (6.1%) adenomas and 73 (65.8%) carcinomas, and the expressional loss was significantly associated with tumor cell differentiation (p<0.05) and survival (p<0.05) in carcinoma.
  • CONCLUSIONS: Alteration of E-cadherin and beta-catenin is a late event during the adenoma-carcinoma sequence in ampullary neoplasms, and the loss of membranous expression of both E-cadherin and beta-catenin is closely correlated with less differentiated histology and poor prognosis.
  • [MeSH-major] Adenoma / metabolism. Adenoma / pathology. Ampulla of Vater. Cadherins / biosynthesis. Carcinoma / metabolism. Carcinoma / pathology. Common Bile Duct Neoplasms / metabolism. Common Bile Duct Neoplasms / pathology. beta Catenin / biosynthesis

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  • (PMID = 16506371.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Cadherins; 0 / beta Catenin
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46. Sato Y, Ohwada S, Oyama T, Kashiwabara K, Totsuka O, Yamada T, Morishita Y: Ampullary carcinoma associated with protein-losing gastropathy due to diffuse varioliform gastritis. Hepatogastroenterology; 2005 Jul-Aug;52(64):1143-6
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  • [Title] Ampullary carcinoma associated with protein-losing gastropathy due to diffuse varioliform gastritis.
  • Protein-losing gastropathy due to diffuse varioliform gastritis is a rare condition, and its occurrence accompanying ampullary carcinoma is particularly rare.
  • We report here a case of ampullary carcinoma accompanied with protein-losing gastroenteropathy due to diffuse varioliform gastritis.
  • Upper gastrointestinal endoscopic examination showed diffuse varioliform gastritis and carcinoma of the papilla of Vater.
  • A diagnosis of protein-losing gastropathy was made based on the results of scintigraphy using technetium 99m-labeled human albumin.
  • Continuous bleeding from ampullary carcinoma caused anemia and deteriorated hypoproteinemia.
  • Pancreaticoduodenectomy was performed for ampullary carcinoma prior to Helicobacter pylori eradication.
  • The tumor was a papillary adenocarcinoma, which had invaded the lamina muscularis propria over the sphincter of Oddi; the resected stomach revealed typical hyperplastic lymphocytic gastritis. H. pylori were detected on microscopic analysis.
  • [MeSH-major] Adenocarcinoma, Papillary / complications. Ampulla of Vater. Common Bile Duct Neoplasms / complications. Gastritis, Hypertrophic / pathology. Protein-Losing Enteropathies / etiology
  • [MeSH-minor] Adult. Female. Helicobacter Infections / diagnosis. Helicobacter Infections / therapy. Helicobacter pylori. Humans. Pancreaticoduodenectomy

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  • (PMID = 16001648.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
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47. Di Giorgio A, Alfieri S, Rotondi F, Prete F, Di Miceli D, Ridolfini MP, Rosa F, Covino M, Doglietto GB: Pancreatoduodenectomy for tumors of Vater's ampulla: report on 94 consecutive patients. World J Surg; 2005 Apr;29(4):513-8
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  • [Title] Pancreatoduodenectomy for tumors of Vater's ampulla: report on 94 consecutive patients.
  • Evaluation of prognostic factors of adenocarcinoma of Vater's ampulla is still a matter of debate.
  • The aim of this study was to evaluate retrospectively factors that influence early and long-term outcomes in a 20-year single-institution experience on ampullary carcinoma.
  • A total of 94 consecutive patients with ampullary carcinoma or adenoma with severe dysplasia were managed from 1981 to 2002.
  • A total of 85 (90.4%) patients had potentially resectable lesions due to the extent of the tumor, but only 64 (68%) underwent curative resection.
  • Survival was found to be significantly affected by resection, tumor size, tumor grade, and tumor infiltration.
  • In a multivariate analysis, only the depth of tumor infiltration influenced patient survival.
  • Pancreatoduodenectomy is the treatment of choice for ampullary carcinoma and adenomas with high-grade dysplasia, with a good chance of long-term survival.
  • [MeSH-major] Adenocarcinoma / surgery. Ampulla of Vater. Common Bile Duct Neoplasms / surgery. Pancreaticoduodenectomy

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  • (PMID = 15776300.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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48. Uchida H, Shibata K, Iwaki K, Kai S, Ohta M, Kitano S: Ampullary cancer and preoperative jaundice: possible indication of the minimal surgery. Hepatogastroenterology; 2009 Jul-Aug;56(93):1194-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Ampullary cancer and preoperative jaundice: possible indication of the minimal surgery.
  • BACKGROUND/AIMS: Obstructive jaundice is common symptom of carcinoma of the ampulla of Vater.
  • CONCLUSIONS: Preoperative jaundice may reflect advanced-stage in case of ampullary cancer.
  • Radical surgery may not be necessary in patients without preoperative jaundice if the tumor is diagnosed as a papillary or well-differentiated adenocarcinoma without lymphatic invasion.
  • [MeSH-major] Adenocarcinoma / surgery. Ampulla of Vater / pathology. Common Bile Duct Neoplasms / surgery. Jaundice, Obstructive / surgery

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  • (PMID = 19760968.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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49. Sohn WJ, Jo S: A huge intraductal papillary mucinous carcinoma of the bile duct treated by right trisectionectomy with caudate lobectomy. World J Surg Oncol; 2009;7:93
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  • BACKGROUND: Because intraductal papillary mucinous neoplasm of the bile duct (IPMN-B) is believed to show a better clinical course than non-papillary biliary neoplasms, it is important to make a precise diagnosis and to perform complete surgical resection.
  • Duodenal endoscopic examination demonstrated very patulous ampullary orifice with mucin expulsion and endoscopic retrograde cholangiogram confirmed marked cystic dilatation of B4 with luminal filling defects.
  • The histopathological examination yielded the diagnosis of mucin-producing oncocytic intraductal papillary carcinoma of the bile duct with poorly differentiated carcinomas showing neuroendocrine differentiation.
  • The tumor was 14.0 x 13.0 cm-sized and revealed no stromal invasiveness.
  • Resection margins of the proximal bile duct and hepatic parenchyma were free of tumor cell.
  • CONCLUSION: Considering a favorable prognosis of IPMN-B compared to non-papillary biliary neoplasms, this tumor can be a good indication for aggressive surgical resection regardless of its tumor size.

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  • (PMID = 19961613.001).
  • [ISSN] 1477-7819
  • [Journal-full-title] World journal of surgical oncology
  • [ISO-abbreviation] World J Surg Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2797779
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50. Kwon J, Lee SE, Kang MJ, Jang JY, Kim SW: A case of gangliocytic paraganglioma in the ampulla of Vater. World J Surg Oncol; 2010;8:42
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A case of gangliocytic paraganglioma in the ampulla of Vater.
  • BACKGROUND: Duodenal gangliocytic paraganglioma is an extremely rare tumor and few cases have been reported to date.
  • CASE PRESENTATION: The authors report a case of gangliocytic paraganglioma verified by post-op pathology after pancreaticoduodenectomy for a tumor in the ampulla of Vater.
  • The patient was diagnosed to have a tumor in the ampulla of Vater with bleeding on its surface.
  • CONCLUSION: This tumor has precise clinical implications, and if continuous follow up is conducted after careful diagnosis and surgical treatment, invasive major operations, such as, radical pancreaticoduodenectomy can be avoided.
  • [MeSH-major] Ampulla of Vater / pathology. Common Bile Duct Neoplasms / pathology. Paraganglioma / pathology

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  • [ISSN] 1477-7819
  • [Journal-full-title] World journal of surgical oncology
  • [ISO-abbreviation] World J Surg Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
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51. Huang SS, Jan YJ, Cheng SB, Yeh DC, Wu CC, Liu TJ, P'eng FK: Large cell neuroendocrine carcinoma of the ampulla of vater: Report of a case. Surg Today; 2006;36(11):1032-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Large cell neuroendocrine carcinoma of the ampulla of vater: Report of a case.
  • Large cell neuroendocrine carcinoma in the ampulla of Vater is rare and very different from the common ampullary adenocarcinoma.
  • Gastroendoscopy showed a swollen ampulla of Vater and pathological examination of an ampullary biopsy revealed findings of a carcinoid tumor.
  • A diagnosis of large cell neuroendocrine carcinoma was confirmed by immunohistochemical examination of the resected specimen.
  • Thus, further investigations are needed to find a more effective postoperative adjuvant chemotherapy agent to treat patients with this aggressive tumor.
  • [MeSH-major] Ampulla of Vater. Carcinoma, Large Cell / pathology. Carcinoma, Neuroendocrine / pathology. Common Bile Duct Neoplasms / pathology
  • [MeSH-minor] Biopsy. Diagnosis, Differential. Endoscopy, Gastrointestinal. Fatal Outcome. Humans. Male. Middle Aged. Pancreaticoduodenectomy

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  • (PMID = 17072731.001).
  • [ISSN] 0941-1291
  • [Journal-full-title] Surgery today
  • [ISO-abbreviation] Surg. Today
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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52. Sakata E, Shirai Y, Yokoyama N, Wakai T, Sakata J, Hatakeyama K: Clinical significance of lymph node micrometastasis in ampullary carcinoma. World J Surg; 2006 Jun;30(6):985-91
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical significance of lymph node micrometastasis in ampullary carcinoma.
  • BACKGROUND: This study aimed to clarify the clinical significance of lymph node micrometastasis in ampullary carcinoma.
  • MATERIALS AND METHODS: Pancreaticoduodenectomy with regional lymphadenectomy was performed for 50 consecutive patients with ampullary carcinoma.
  • CONCLUSIONS: Immunohistochemically detected lymph node micrometastasis indicates intensive lymphatic spread, and thus adversely affects the survival of patients with ampullary carcinoma.
  • [MeSH-major] Ampulla of Vater. Common Bile Duct Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / analysis. Female. Humans. Immunohistochemistry. Keratins / analysis. Lymph Node Excision. Lymph Nodes / chemistry. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Invasiveness. Pancreaticoduodenectomy. Prognosis. Survival Rate

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  • (PMID = 16736326.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 68238-35-7 / Keratins
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53. Yoon YS, Kim SW, Park SJ, Lee HS, Jang JY, Choi MG, Kim WH, Lee KU, Park YH: Clinicopathologic analysis of early ampullary cancers with a focus on the feasibility of ampullectomy. Ann Surg; 2005 Jul;242(1):92-100
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  • [Title] Clinicopathologic analysis of early ampullary cancers with a focus on the feasibility of ampullectomy.
  • OBJECTIVE: The purpose of this study was to evaluate whether ampullectomy can substitute for pancreatoduodenectomy (PD) in early ampullary cancer by clinicopathologic study.
  • SUMMARY BACKGROUND DATA: Although ampullectomy has been attempted in early ampullary cancer (pTis, pT1), the indication and extent of resection have not been established.
  • METHODS: Of 201 patients who had undergone PD for ampullary cancer between 1986 and 2002, 67 patients with a histologic diagnosis of pTis (n = 5) or pT1 (n = 62) cancer were analyzed retrospectively.
  • RESULTS: The 5-year survival rate of the 66 patients with early ampullary cancer (excluding one mortality) was 83.7%.
  • Pathologic review showed that 22 patients (32.8%) had at least one risk factor for failure after ampullectomy: lymph node metastasis (n = 6, 9.0%), perineural invasion (n = 1), or mucosal tumor infiltration along the CBD or P-duct (n = 15, 22.4%).
  • Moreover, these risk factors were not correlated with tumor size, histologic grade, or the gross morphology of the primary tumor, although pTis cancer or pT1 cancer sized 1.0 cm or less was found to be least associated with risk factors.
  • CONCLUSIONS: Ampullectomy for early ampullary cancer should not be considered an alternative operation to PD because of the high possibility of recurrence.
  • PD should be preferably performed for adequate radical resection, even in early ampullary cancer, and ampullectomy should be reserved for those who have pTis or pT1 cancer sized 1.0 cm or less with high operative risk.
  • [MeSH-major] Ampulla of Vater / surgery. Common Bile Duct Neoplasms / pathology. Common Bile Duct Neoplasms / surgery. Lymph Nodes / pathology. Neoplasm Recurrence, Local / mortality

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  • (PMID = 15973106.001).
  • [ISSN] 0003-4932
  • [Journal-full-title] Annals of surgery
  • [ISO-abbreviation] Ann. Surg.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC1357709
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54. Matsushita M, Kobayashi Y, Kobayashi H, Nagasawa M, Sato Y, Nakamura H: A case of gastrointestinal stromal tumour of the ampulla of Vater. Dig Liver Dis; 2005 Apr;37(4):275-7
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  • [Title] A case of gastrointestinal stromal tumour of the ampulla of Vater.
  • Gastrointestinal stromal tumour rarely develops in the duodenal ampulla region.
  • We report here a case of gastrointestinal stromal tumour of the ampulla of Vater found in a 44-year-old Japanese man presenting with biliary obstruction.
  • The postmortem examination showed a large Borrman type III-like tumour in the duodenal ampullary region with direct invasion of the pancreas and extrahepatic bile duct as well as metastases to the liver and regional lymph nodes.
  • The duct orifice was located at the centre of the tumour.
  • Microscopically, the tumour consisted of anaplastic spindle cells with high mitotic activity (90 mitoses per 50 high-power fields).
  • The final diagnosis was high-grade malignant gastrointestinal stromal tumour of the ampulla of Vater.
  • Considering the recent advances in the diagnosis and treatment of gastrointestinal stromal tumour, this neoplasm should be included in the differential diagnosis of the tumours appearing in the duodenal ampulla region.
  • [MeSH-major] Ampulla of Vater / pathology. Common Bile Duct Neoplasms / pathology. Gastrointestinal Stromal Tumors / pathology

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  • (PMID = 15788212.001).
  • [ISSN] 1590-8658
  • [Journal-full-title] Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
  • [ISO-abbreviation] Dig Liver Dis
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Antigens, CD34; EC 2.7.10.1 / Proto-Oncogene Proteins c-kit
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55. Winter JM, Cameron JL, Olino K, Herman JM, de Jong MC, Hruban RH, Wolfgang CL, Eckhauser F, Edil BH, Choti MA, Schulick RD, Pawlik TM: Clinicopathologic analysis of ampullary neoplasms in 450 patients: implications for surgical strategy and long-term prognosis. J Gastrointest Surg; 2010 Feb;14(2):379-87
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinicopathologic analysis of ampullary neoplasms in 450 patients: implications for surgical strategy and long-term prognosis.
  • BACKGROUND: Whether ampullary neoplasms are best surgically managed by pancreaticoduodenectomy versus local ampullectomy is controversial.
  • We sought to examine the outcome of patients undergoing pancreaticoduodenectomy versus ampullectomy, as well as to identify factors predictive of lymph node metastasis in patients with ampullary neoplasms.
  • METHODS: Between 1970 and 2007, 450 patients who underwent surgical resection of ampullary adenoma or adenocarcinoma were identified from a prospective, single-institution database.
  • Final diagnosis was invasive adenocarcinoma (77.1%) or adenoma (22.9%).
  • Median tumor size was similar for adenomas associated with an adenocarcinoma (2.5 cm) versus adenomas without invasive cancer (2.9 cm; P=0.71).
  • Factors associated with presence of lymph node metastasis included tumor size > or = 1 cm (OR 2.1), poor histologicgrade (OR 4.8), perineural invasion (OR 3.0), microscopic vessel invasion (OR 6.6), and depth of invasion > pT1 (OR 4.3; all P<0.05).
  • CONCLUSION: When surgery is indicated, radical resection is required for early invasive adenocarcinoma of the ampulla of Vater, as lymph node metastases are present in nearly 30% of patients with T1 disease.
  • Pancreaticoduodenectomy should be the preferred approach for most ampullary neoplasms that require surgical resection.
  • [MeSH-major] Adenocarcinoma / surgery. Adenoma / surgery. Ampulla of Vater / surgery. Common Bile Duct Neoplasms / surgery

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  • (PMID = 19911239.001).
  • [ISSN] 1873-4626
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Grant] United States / NCRR NIH HHS / RR / 1KL2RR025006-01
  • [Publication-type] Comparative Study; Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
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56. Riediger H, Makowiec F, Fischer E, Adam U, Hopt UT: Postoperative morbidity and long-term survival after pancreaticoduodenectomy with superior mesenterico-portal vein resection. J Gastrointest Surg; 2006 Sep-Oct;10(8):1106-15
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The role of superior mesenteric-portal vein resection (SM-PVR) for vein invasion or tumor adherence during pancreatoduodenectomy (PD) is still under debate.
  • Long-term survival was analyzed in 165 patients with pancreatic (n = 110), ampullary (n = 33), or distal bile (n = 22) duct cancer using univariate (log-rank) and multivariate (Cox regression) methods.
  • In patients undergoing PD with SM-PVR and conclusive histologic examination of the resected vein specimen (n = 42), 60% had true tumor involvement of the venous wall, whereas 40% had no proven tumor infiltration.
  • Five-year survival rates were 15% in cancer of the pancreatic head, 22% in ampullary cancer, and 24% in distal bile duct cancer (P = 0.02).
  • Long-term survival was not influenced by the need for SM-PVR in any of the different tumor entities.
  • In multivariate analysis, a positive resection margin (P < 0.01, relative risk [RR]: 1.8, 95% confidence interval [CI]: 1.2-2.7), a histologically undifferentiated tumor (P = 0.01, RR: 1.7, 95% CI: 1.1-2.5), and the tumor entity (P < 0.01) were significant predictors of survival.
  • Univariate survival analysis of the 110 patients with cancer of the pancreatic head revealed that a histologically undifferentiated tumor (P = 0.05) and positive resection margins (P = 0.02) were associated with a poorer survival.
  • In multivariate analysis, the resection margin (P = 0.02, RR: 5.1, 95% CI: 1.1-2.8) and a histologically undifferentiated tumor (P = 0.05, RR: 3.8, 95% CI: 1.0-2.5) significantly influenced survival.
  • In case of tumor adherence or infiltration, combined resection of the pancreatic head and the vein should always be considered in the absence of other contraindications for resection.
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Female. Follow-Up Studies. Humans. Male. Middle Aged. Morbidity / trends. Neoplasm Invasiveness. Postoperative Period. Prospective Studies. Survival Rate. Time Factors. Treatment Outcome

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  • (PMID = 16966029.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] United States
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57. Chen CH, Yang CC, Yeh YH, Chou DA, Nien CK: Reappraisal of endosonography of ampullary tumors: correlation with transabdominal sonography, CT, and MRI. J Clin Ultrasound; 2009 Jan;37(1):18-25
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Reappraisal of endosonography of ampullary tumors: correlation with transabdominal sonography, CT, and MRI.
  • PURPOSE: To reappraise the accuracy of transabdominal sonography (US), CT, MRI, and endosonography (EUS) in the diagnosis and staging of ampullary tumors.
  • METHOD: We reviewed the medical records and the images of 41 consecutive patients with ampullary tumors.
  • Tumor detection rate and accuracy of TNM (tumor-node-metastasis) staging of malignant tumors were determined.
  • RESULTS: The detection rates for ampullary tumors were 97.6% for EUS, 81.3% for MRI, 28.6% for CT, and 12.2% for US (p < 0.001 for EUS versus CT; p < 0.001 for EUS versus US; p > 0.05 for EUS versus MRI).
  • The accuracy in T staging for ampullary carcinomas was 72.7% for EUS, 53.8% for MRI, and 26.1% for CT (p < 0.01 for EUS versus CT; p > 0.05 for EUS versus MRI).
  • The accuracy in N staging for ampullary carcinomas was 66.7% for EUS, 76.9% for MRI, and 43.5% for CT with no statistically significant difference between the 3 modalities.
  • Transpapillary stenting, advanced tumor extension (>T2), large tumor size (>2 cm), tumor differentiation, and endoscopic appearance of tumor growth did not significantly influence EUS accuracy in T or N staging (p > 0.05).
  • CONCLUSION: EUS was superior to CT and was equivalent to MRI for tumor detection and T and N staging of ampullary tumors.
  • Neither indwelling stents nor tumor size, differentiation, or endoscopic appearance affected the staging accuracy of EUS.
  • [MeSH-major] Ampulla of Vater. Common Bile Duct Neoplasms / ultrasonography. Endosonography. Magnetic Resonance Imaging. Pancreatic Neoplasms / ultrasonography. Tomography, X-Ray Computed
  • [MeSH-minor] Abdomen / ultrasonography. Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Neoplasm Staging. Retrospective Studies

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  • [Copyright] (c) 2008 Wiley Periodicals, Inc.
  • (PMID = 18726967.001).
  • [ISSN] 1097-0096
  • [Journal-full-title] Journal of clinical ultrasound : JCU
  • [ISO-abbreviation] J Clin Ultrasound
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
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58. DeWitt J, Alsatie M, LeBlanc J, McHenry L, Sherman S: Endoscopic ultrasound-guided fine-needle aspiration of left adrenal gland masses. Endoscopy; 2007 Jan;39(1):65-71
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  • RESULTS: Our searches resulted in the identification of a series of 38 consecutive patients who underwent EUS for the evaluation of a lung mass (n = 14), a pancreatic mass (n = 14), obstructive jaundice (n = 1), dysphagia (n = 2), an ampullary adenoma (n = 1), celiac block (n = 1), or a left adrenal gland mass (n = 5).
  • Diagnoses after EUS-FNA (the mean number of passes was 3.6) were: metastatic lung cancer (n = 2), esophageal adenocarcinoma (n = 1), melanoma (n = 1), renal cell carcinoma (n = 1), and pancreatic neuroendocrine tumor (n = 1); primary pheochromocytoma (n = 1); benign adrenal tissue (n = 21); and granulomatous inflammation (n = 1).


59. Kawaguchi T, Ochiai T, Ikoma H, Inoue K, Morimura R, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Nakanishi M, Ichikawa D, Okamoto K, Fujiwara H, Kokuba Y, Sonoyama T, Otsuji E: Prognostic impact of histological blood vessel invasion in patients with ampullary adenocarcinoma. Hepatogastroenterology; 2010 Nov-Dec;57(104):1347-50
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  • [Title] Prognostic impact of histological blood vessel invasion in patients with ampullary adenocarcinoma.
  • BACKGROUNDS/AIMS: Ampullary adenocarcinoma (AmpCA) has a greater overall survival (OS) rate than other periampullary cancers such as pancreatic cancer or bile duct cancer.
  • The mean age was 65.6 and mean +/- S.D. tumor size was 2.08 +/- 1.13 cm.
  • [MeSH-major] Adenocarcinoma / pathology. Adenocarcinoma / surgery. Ampulla of Vater / pathology. Common Bile Duct Neoplasms / pathology. Common Bile Duct Neoplasms / surgery. Vascular Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Female. Humans. Male. Middle Aged. Neoplasm Invasiveness. Pancreaticoduodenectomy. Prognosis. Proportional Hazards Models. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 21443083.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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60. Santini D, Perrone G, Vincenzi B, Lai R, Cass C, Alloni R, Rabitti C, Antinori A, Vecchio F, Morini S, Magistrelli P, Coppola R, Mackey JR, Tonini G: Human equilibrative nucleoside transporter 1 (hENT1) protein is associated with short survival in resected ampullary cancer. Ann Oncol; 2008 Apr;19(4):724-8
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  • [Title] Human equilibrative nucleoside transporter 1 (hENT1) protein is associated with short survival in resected ampullary cancer.
  • Moreover, recent reports indicate a significant correlation between immunohistochemical variations of hENT1 in tumor samples and survival after gemcitabine therapy in patients with solid tumors.
  • MATERIALS AND METHODS: We used immunohistochemistry to assess the abundance and distribution of hENT1 in tumor samples from radically resected cancer of the ampulla, and sought correlations between immunohistochemical results and clinical parameters including disease outcomes.
  • No statistical significant differences were found between immunohistochemical findings and patient characteristics (sex, age, and tumor-node-metastasis).
  • CONCLUSIONS: hENT1 expression is a molecular prognostic marker for patients with resected ampullary cancer and holds promise as a predictive factor to assist in chemotherapy decisions.

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  • (PMID = 18187485.001).
  • [ISSN] 1569-8041
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / Equilibrative Nucleoside Transporter 1; 0 / Ki-67 Antigen; 0 / SLC29A1 protein, human
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61. Manzanares MC, Villarejo P, López A, Padilla D, Cubo T, d e la Plaza R, Jara A, Martínez F, Menchén B, Molina JM, Pardo R, Martín J, García M: [Immunohystochemical and prognosis features of adenocarcinoid tumor of the ampulla of Vater]. Rev Esp Enferm Dig; 2006 Dec;98(12):966-8
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  • [Title] [Immunohystochemical and prognosis features of adenocarcinoid tumor of the ampulla of Vater].
  • [Transliterated title] Aspectos inmunohistoquímicos y pronósticos del tumor adenocarcinoide de la ampolla de Vater.
  • [MeSH-major] Ampulla of Vater / pathology. Carcinoid Tumor / pathology. Common Bile Duct Neoplasms / pathology

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  • (PMID = 17274703.001).
  • [ISSN] 1130-0108
  • [Journal-full-title] Revista española de enfermedades digestivas : organo oficial de la Sociedad Española de Patología Digestiva
  • [ISO-abbreviation] Rev Esp Enferm Dig
  • [Language] spa
  • [Publication-type] Case Reports; Letter
  • [Publication-country] Spain
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62. Hwang S, Lee SG, Lee YJ, Han DJ, Kim SC, Kwon SH, Ryu JH, Park JI, Lee HJ, Choi GW, Yu ES: Radical surgical resection for carcinoid tumors of the ampulla. J Gastrointest Surg; 2008 Apr;12(4):713-7
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  • [Title] Radical surgical resection for carcinoid tumors of the ampulla.
  • Ampullary carcinoid tumors are extremely rare.
  • The present study describes the clinicopathological features and outcomes for 10 ampullary carcinoid patients who underwent radical resection from 1998 to 2005.
  • During this study period, 294 patients underwent pancreatoduodenectomy for ampullary neoplasms in our institution.
  • The mean tumor size and volume were 2.1 +/- 1.3 cm and 4.1 +/- 6.9 ml, respectively.
  • Univariate analyses revealed that a maximal tumor diameter > or =2 cm and tumor extension beyond the ampulla were risk factors for tumor recurrence.
  • In conclusion, while the majority of ampullary carcinoids are indolent, this tumor is associated with a relatively poor prognosis.
  • We believe that radical resection, with the aim of complete tumor removal and cure, is the treatment of choice.
  • [MeSH-major] Ampulla of Vater. Carcinoid Tumor / surgery. Common Bile Duct Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Chromogranins / analysis. Female. Histocytochemistry. Humans. Liver Neoplasms / secondary. Male. Middle Aged. Neoplasm Recurrence, Local. Pancreaticoduodenectomy. Prognosis. Risk Factors. Survival Rate. Synaptophysin / analysis

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  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
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63. Yao HS, Wang Q, Wang WJ, Hu ZQ: Intraoperative allogeneic red blood cell transfusion in ampullary cancer outcome after curative pancreatoduodenectomy: a clinical study and meta-analysis. World J Surg; 2008 Sep;32(9):2038-46
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  • [Title] Intraoperative allogeneic red blood cell transfusion in ampullary cancer outcome after curative pancreatoduodenectomy: a clinical study and meta-analysis.
  • This study examined whether intraoperative allogeneic RBC transfusion is an independent risk factor of adverse outcome in patients with ampullary carcinoma after curative pancreatoduodenectomy.
  • METHODS: The clinical data of 67 patients with carcinoma of the ampulla of Vatar underwent pancreatoduodenectomy between 1999 and 2004 were analyzed, and long-term follow-up visits were made for all patients.
  • For the meta-analysis, all English-language studies regarding blood transfusion from carcinoma of the ampulla of Vatar or ampullary carcinoma and prognostic factors or factors for survival from 1995 to 2007 were reviewed, and contingency tables were constructed from which a summary relative risk was calculated.
  • Forty-five patients (67.2%) died as a result of tumor progression.
  • After multivariate analysis, except for presence of lymph node metastasis (P = 0.023) and pancreatic invasion (P = 0.024), the intraoperative ABT > or =3 units was found to be an independent poor prognostic factor for those with ampullary cancer after curative pancreatoduodenectomy either (relative risk, 2.082; 95% confidence interval (CI), 1.048-4.135; P = 0.036).
  • CONCLUSIONS: The amount of intraoperative ABT is one of the important factors that adversely influenced survival in patients with ampullary cancer after curative pancreatoduodenectomy.
  • [MeSH-major] Ampulla of Vater / surgery. Erythrocyte Transfusion. Pancreatic Neoplasms / surgery. Pancreaticoduodenectomy
  • [MeSH-minor] Adult. Aged. Blood Loss, Surgical. Blood Transfusion, Autologous. Chi-Square Distribution. Female. Humans. Intraoperative Care. Male. Middle Aged. Neoplasm Staging. Prognosis. Proportional Hazards Models. Risk Factors. Survival Analysis. Treatment Outcome

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  • (PMID = 18584239.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article; Meta-Analysis
  • [Publication-country] United States
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64. Zhang MQ, Chen ZM, Wang HL: Immunohistochemical investigation of tumorigenic pathways in small intestinal adenocarcinoma: a comparison with colorectal adenocarcinoma. Mod Pathol; 2006 Apr;19(4):573-80
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  • Small intestinal adenocarcinoma is an uncommon neoplasm morphologically similar to or indistinguishable from colorectal adenocarcinoma.
  • In this study, we immunohistochemically compared non-ampullary small intestinal adenocarcinomas with sporadic colorectal adenocarcinomas for the expression of several proteins known to serve pivotal roles in colorectal tumorigenesis.
  • The expression of two important tumor suppressors, p53 and RB, was also examined.
  • [MeSH-minor] Adaptor Proteins, Signal Transducing. Adenomatous Polyposis Coli Protein / analysis. Carrier Proteins / analysis. Cell Transformation, Neoplastic. DNA-Binding Proteins / analysis. Humans. Immunohistochemistry. Neoplasm Proteins / analysis. Nuclear Proteins / analysis. Retinoblastoma Protein / analysis. Signal Transduction. Tumor Suppressor Protein p53 / analysis. beta Catenin / analysis

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  • (PMID = 16501564.001).
  • [ISSN] 0893-3952
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adaptor Proteins, Signal Transducing; 0 / Adenomatous Polyposis Coli Protein; 0 / Carrier Proteins; 0 / DNA-Binding Proteins; 0 / G-T mismatch-binding protein; 0 / MLH1 protein, human; 0 / MLH2 protein, human; 0 / Neoplasm Proteins; 0 / Nuclear Proteins; 0 / Retinoblastoma Protein; 0 / TP53 protein, human; 0 / Tumor Suppressor Protein p53; 0 / beta Catenin
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65. Petrowsky H, Clavien PA: Should we deny surgery for malignant hepato-pancreatico-biliary tumors to elderly patients? World J Surg; 2005 Sep;29(9):1093-100
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  • Similar findings are also reported for pancreatic resection in elderly patients with either ampullary or pancreatic cancer.
  • Therefore, surgical options should not be denied to elderly patients with a malignant HPB tumor, and the evaluation should include surgeons expert in HPB surgery.

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  • (PMID = 16086216.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 52
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66. Wagle PK, Shetty GS, Sampat M, Patel K: Ectopic pancreatic tissue mimicking ampullary tumor. Indian J Gastroenterol; 2005 Nov-Dec;24(6):265-6
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  • [Title] Ectopic pancreatic tissue mimicking ampullary tumor.
  • Ectopic pancreas is an anomaly in the fusion of the two pancreatic buds where an ectopic rest develops at a place away from the normal site.
  • We report a 70-year-old lady who presented with obstructive jaundice; she was found to have an ampullary tumor highly suggestive of malignancy, for which she underwent pancreatico-duodenectomy.
  • However, histology showed ectopic pancreatic tissue in the ampulla.
  • [MeSH-major] Ampulla of Vater. Choristoma / diagnosis. Common Bile Duct Diseases / diagnosis. Common Bile Duct Neoplasms / diagnosis. Pancreas
  • [MeSH-minor] Aged. Diagnosis, Differential. Female. Humans

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  • (PMID = 16424630.001).
  • [ISSN] 0254-8860
  • [Journal-full-title] Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology
  • [ISO-abbreviation] Indian J Gastroenterol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] India
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67. Singhal D, Kumar M, Sud R, Chaudhary A: Image of the month. Gastrointestinal Stromal Tumor of the Ampulla of Vater. Arch Surg; 2007 Sep;142(9):899-900
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Image of the month. Gastrointestinal Stromal Tumor of the Ampulla of Vater.
  • [MeSH-major] Ampulla of Vater / ultrasonography. Endosonography. Gastrointestinal Stromal Tumors / ultrasonography
  • [MeSH-minor] Aged. Diagnosis, Differential. Humans. Male

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  • (PMID = 17875846.001).
  • [ISSN] 0004-0010
  • [Journal-full-title] Archives of surgery (Chicago, Ill. : 1960)
  • [ISO-abbreviation] Arch Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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68. Deschamps L, Dokmak S, Guedj N, Ruszniewski P, Sauvanet A, Couvelard A: Mixed endocrine somatostatinoma of the ampulla of vater associated with a neurofibromatosis type 1: a case report and review of the literature. JOP; 2010;11(1):64-8
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  • [Title] Mixed endocrine somatostatinoma of the ampulla of vater associated with a neurofibromatosis type 1: a case report and review of the literature.
  • CONTEXT: Mixed endocrine tumors are double neoplasms with both glandular and endocrine components; these tumors are rare, especially those arising in the ampulla of Vater.
  • Ampullary somatostatinomas are classically associated with neurofibromatosis type 1.
  • We herein describe the first reported case of a mixed endocrine somatostatinoma of the ampulla of Vater associated with neurofibromatosis type 1; we also present a review of the literature of the 7 mixed endocrine tumors of the ampulla which have been reported so far.
  • Endoscopic examination revealed a tumor involving the ampulla of Vater and a CT scan identified stenoses of both the distal common bile duct and the main pancreatic duct.
  • A pancreaticoduodenectomy was performed and pathological examination revealed two tumor components, exocrine (high grade adenoma with infiltrative adenocarcinoma) and endocrine (expressing somatostatin hormone) with lymph node metastases originating from both types.
  • DISCUSSION: In ampullary somatostatinomas, psammoma bodies are pathognomonic and chromogranin A is rarely expressed: these features should alert the pathologist to an association with neurofibromatosis type 1.
  • The treatment of choice is surgery, and adjuvant chemotherapy should be adapted to the most aggressive component, i.e. the exocrine one.
  • CONCLUSION: Because of their rarity, the diagnosis of ampullary mixed endocrine tumors is difficult.
  • [MeSH-major] Ampulla of Vater. Common Bile Duct Neoplasms / diagnosis. Mixed Tumor, Malignant / diagnosis. Neurofibromatosis 1 / diagnosis. Somatostatinoma / diagnosis


69. Hustinx SR, Fukushima N, Zahurak ML, Riall TS, Maitra A, Brosens L, Cameron JL, Yeo CJ, Offerhaus GJ, Hruban RH, Goggins M: Expression and prognostic significance of 14-3-3sigma and ERM family protein expression in periampullary neoplasms. Cancer Biol Ther; 2005 May;4(5):596-601
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  • We investigated the prognostic significance of aberrant expression of 14-3-3sigma and the ERM proteins (Ezrin, radixin, Moesin) in a series of invasive periampullary adenocarcinomas including 300 infiltrating pancreatic adenocarcinomas, 54 ampullary adenocarcinomas, and 33 noninvasive intraductal papillary mucinous neoplasms from patients who underwent pancreaticoduodenal resection at The Johns Hopkins Hospital, Baltimore, MD, between 1991 and 2003.
  • Two-hundred fourty-four (82%) primary infiltrating adenocarcinomas of the pancreas demonstrated positive expression of the 14-3-3sigma, 45 (15%) showed weak immunolabelling, and 9 (3%) were negative.
  • A similar proportion of ampullary cancers showed 14-3-3sigma and ERM protein expression.
  • [MeSH-major] Ampulla of Vater / metabolism. Biomarkers, Tumor / metabolism. Common Bile Duct Diseases / metabolism. DNA-Binding Proteins / metabolism. Exonucleases / metabolism. Neoplasm Proteins / metabolism. Pancreatic Neoplasms / diagnosis. Pancreatic Neoplasms / metabolism. Transcription Factors / metabolism

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  • (PMID = 15908786.001).
  • [ISSN] 1538-4047
  • [Journal-full-title] Cancer biology & therapy
  • [ISO-abbreviation] Cancer Biol. Ther.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / 14-3-3 Proteins; 0 / Biomarkers, Tumor; 0 / DNA-Binding Proteins; 0 / ETV5 protein, human; 0 / Neoplasm Proteins; 0 / Transcription Factors; EC 3.1.- / Exonucleases; EC 3.1.- / Exoribonucleases; EC 3.1.- / SFN protein, human
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70. Katsinelos P, Kountouras J, Zavos C, Chatzimavroudis G, Paroutoglou G: Recurrent acute pancreatitis caused by intra-ampullary carcinoid tumor. Gastrointest Endosc; 2009 Jun;69(7):1387-8; discussion 1388
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  • [Title] Recurrent acute pancreatitis caused by intra-ampullary carcinoid tumor.
  • [MeSH-major] Ampulla of Vater. Carcinoid Tumor / complications. Common Bile Duct Neoplasms / complications. Pancreatitis / etiology


71. Ghidirim G, Rojnoveanu G, Mişin I, Cernîi A, Gurghiş R: [Carcinoid of the minor duodenal papilla associated with multiple jejunal leiomyomas in type 1 neurofibromatosis]. Chirurgia (Bucur); 2009 Jul-Aug;104(4):491-4
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  • Carcinoids of the ampulla of Vater are the most rare primary ampullary tumors.
  • [MeSH-major] Ampulla of Vater. Carcinoid Tumor / complications. Duodenal Neoplasms / complications. Jejunal Neoplasms / complications. Leiomyoma / complications. Neoplasms, Multiple Primary / complications. Neurofibromatosis 1 / complications. Pancreatic Ducts


72. Jayaprakash N, O'Kelly F, Lim KT, Reynolds JV: Management of synchronous adenocarcinoma of the esophago-gastric junction and ampulla of Vater: case report of a surgically challenging condition. Patient Saf Surg; 2009;3(1):23
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  • [Title] Management of synchronous adenocarcinoma of the esophago-gastric junction and ampulla of Vater: case report of a surgically challenging condition.
  • We report herein a case of a synchronous presentation of an adenocarcinoma of esophagago-gastric junction type II and an ampullary tumor that was treated by combined Whipple's pancreaticoduodenectomy, total gastrectomy and esophagectomy.

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  • [Cites] Yonsei Med J. 2007 Dec 31;48(6):981-7 [18159590.001]
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  • (PMID = 19785744.001).
  • [ISSN] 1754-9493
  • [Journal-full-title] Patient safety in surgery
  • [ISO-abbreviation] Patient Saf Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2760510
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73. Kim S, Lee NK, Lee JW, Kim CW, Lee SH, Kim GH, Kang DH: CT evaluation of the bulging papilla with endoscopic correlation. Radiographics; 2007 Jul-Aug;27(4):1023-38
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  • A variety of pathologic conditions can cause abnormalities of the ampulla of Vater.
  • A bulging papilla is frequently encountered at computed tomography (CT) and can be seen in healthy individuals as well as in patients with various pathologic conditions such as papillitis, ampullary cancer, and intraductal papillary mucinous tumor.
  • Increased targetlike enhancement of the papilla is likely to represent a benign condition such as papillitis, whereas an enhancing polypoid mass or focal asymmetric or irregular thickening with prolonged enhancement in the ampulla of Vater indicates a malignant condition such as ampullary or periampullary carcinoma.
  • However, endoscopy with or without biopsy is the best method for making a definitive diagnosis in patients with a bulging papilla.
  • Familiarity with the normal imaging anatomy of the periampullary region and with the imaging features of the various pathologic causes of a bulging papilla may be useful in making the diagnosis.
  • [MeSH-major] Bile Duct Diseases / diagnosis. Bile Ducts / pathology. Cholangiography / methods. Endoscopy / methods. Magnetic Resonance Imaging / methods. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Diagnosis, Differential. Female. Humans. Infant. Male. Middle Aged. Practice Guidelines as Topic. Practice Patterns, Physicians'. Statistics as Topic

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  • [Copyright] RSNA, 2007
  • (PMID = 17620465.001).
  • [ISSN] 1527-1323
  • [Journal-full-title] Radiographics : a review publication of the Radiological Society of North America, Inc
  • [ISO-abbreviation] Radiographics
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 30
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74. Sen N, Calli Demirkan N, Aksoy Altinboğa A, Bolat H, Erdem E: Synchronous endocrine tumors of small intestine: report of a case. Turk J Gastroenterol; 2008 Sep;19(3):193-6
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  • A 90-year-old man was operated due to tumor of the ampulla of Vater.
  • As the surgical specimen was examined macroscopically, a second tumor focus, measuring 1 cm in diameter, was detected at the duodenum.
  • Microscopically, the ampullary tumor had trabecular and rosette-like patterns, with many necrotic areas.
  • The latter duodenal tumor was located in the submucosa and had distinct borders.
  • This tumor consisted of trabecular structures with stroma rich in lymphoid aggregates.
  • The tumors were diagnosed as well-differentiated endocrine carcinoma in the ampulla of Vater according to the WHO classification 2000, a gastrin-producing well-differentiated endocrine tumor in the first portion of the duodenum without regional lymph node metastases, and a diffuse parietal cell hyperplasia at the antral portion of the stomach.
  • In conclusion, clinical findings and the postoperative diagnosis suggest that this patient had primary synchronous neuroendocrine tumors of the small intestine.
  • [MeSH-major] Ampulla of Vater. Endocrine Gland Neoplasms / diagnosis. Intestinal Neoplasms / diagnosis. Intestine, Small. Neoplasms, Multiple Primary / diagnosis
  • [MeSH-minor] Aged, 80 and over. Diagnosis, Differential. Fatal Outcome. Humans. Male

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  • (PMID = 19115157.001).
  • [ISSN] 2148-5607
  • [Journal-full-title] The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology
  • [ISO-abbreviation] Turk J Gastroenterol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Turkey
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75. Peng SY, Hong DF, Liu YB, Tan ZJ, Li JT, Tao F: [Binding pancreaticogastrostomy]. Zhonghua Wai Ke Za Zhi; 2009 Jan 15;47(2):139-42
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • METHODS: From May 2008 to October 2008, 15 patients were performed with BPG, included pancreatic head cancer in 7 cases, duodenal adenocarcinoma in 2 cases,mass-type chronic pancreatitis with pancreatolithiasis in 1 case, ampullary carcinoma in 1 case, gallbladder cancer in 1 case, islet cell tumor in 1 case and cholangiocarcinoma in 2 cases.
  • The main procedures of BPG included: isolating remnant pancreas; slitting partial posterior wall of stomach and preplaced with seromuscular purse-string suture; cutting gastric anterior wall; performing pancreaticogastrostomy (binding of outer seromuscular and inner mucous layer of stomach).
  • [MeSH-major] Pancreas / surgery. Stomach / surgery

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  • (PMID = 19563012.001).
  • [ISSN] 0529-5815
  • [Journal-full-title] Zhonghua wai ke za zhi [Chinese journal of surgery]
  • [ISO-abbreviation] Zhonghua Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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76. Chang S, Lim JH, Choi D, Kim SK, Lee WJ: Differentiation of ampullary tumor from benign papillary stricture by thin-section multidetector CT. Abdom Imaging; 2008 Jul-Aug;33(4):457-62
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Differentiation of ampullary tumor from benign papillary stricture by thin-section multidetector CT.
  • The objective of this paper was to determine the criteria for differentiation of ampullary tumor from benign papillary stricture using thin-section multidetector CT images.
  • Multidetector CT images with 2.5 mm slice-thickness in 57 consecutive patients (24 with ampulla of Vater tumor and 33 with benign papillary stricture) with extrahepatic duct dilatation due to ampullary obstruction were reviewed retrospectively.
  • Multiple logistic regression analysis showed the papilla/papillary mass size was the only independently differentiating variable of ampullary tumor from benign stricture (P = 0.016) with an odds ratio of 2.424 (95% confidence interval, 1.179-4.903).
  • Ampullary tumor and benign papillary stricture could be effectively differentiated by thin-section multidetector CT based on papilla/papillary mass size.
  • [MeSH-major] Ampulla of Vater / pathology. Common Bile Duct Diseases / radiography. Common Bile Duct Neoplasms / radiography. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Constriction, Pathologic / radiography. Diagnosis, Differential. Female. Humans. Logistic Models. Male. Middle Aged. Sensitivity and Specificity

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  • (PMID = 17712590.001).
  • [ISSN] 1432-0509
  • [Journal-full-title] Abdominal imaging
  • [ISO-abbreviation] Abdom Imaging
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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77. Kim RD, Kundhal PS, McGilvray ID, Cattral MS, Taylor B, Langer B, Grant DR, Zogopoulos G, Shah SA, Greig PD, Gallinger S: Predictors of failure after pancreaticoduodenectomy for ampullary carcinoma. J Am Coll Surg; 2006 Jan;202(1):112-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Predictors of failure after pancreaticoduodenectomy for ampullary carcinoma.
  • BACKGROUND: Complete resection offers the only potential cure for ampullary carcinoma.
  • We analyzed factors that contribute to treatment failure and survival in patients who underwent pancreaticoduodenectomy for ampullary carcinoma.
  • STUDY DESIGN: We retrospectively reviewed all patients who underwent pancreaticoduodenectomy between August 1994 and August 2003 for ampullary carcinoma.
  • Further analysis revealed that nodal status (p < 0.001), but not tumor grade, was a significant predictor of treatment failure.
  • CONCLUSIONS: Tumor stage is associated with treatment failure after pancreaticoduodenectomy for ampullary carcinoma and may identify candidates for adjuvant therapy.
  • Because an aggressive surgical approach can be adopted safely with the best chance for cure, we recommend that pancreaticoduodenectomy be offered to all patients with ampullary tumors when malignancy or dysplasia is in question.
  • [MeSH-major] Adenocarcinoma / surgery. Ampulla of Vater. Common Bile Duct Neoplasms / surgery. Pancreaticoduodenectomy

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  • (PMID = 16377504.001).
  • [ISSN] 1072-7515
  • [Journal-full-title] Journal of the American College of Surgeons
  • [ISO-abbreviation] J. Am. Coll. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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78. Speer C: A photodynamic therapy for ampullary cancer. Gastroenterol Nurs; 2006 Sep-Oct;29(5):398-400
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  • [Title] A photodynamic therapy for ampullary cancer.
  • For this procedure, a photosensitizing drug is applied endoscopically followed by a laser light beam that is directed onto the tumor, facilitating a photochemical reaction.
  • [MeSH-major] Ampulla of Vater. Common Bile Duct Neoplasms / drug therapy. Palliative Care / methods. Pancreatic Neoplasms / drug therapy. Photochemotherapy / methods

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  • (PMID = 17038844.001).
  • [ISSN] 1042-895X
  • [Journal-full-title] Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates
  • [ISO-abbreviation] Gastroenterol Nurs
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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79. Ferrando Marco J, Pallas Regueira A, Moro Valdezate D, Fernández Martínez C: [Collision tumor of the ampulla of Vater: carcinoid and adenocarcinoma]. Rev Esp Enferm Dig; 2007 Apr;99(4):235-8
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  • [Title] [Collision tumor of the ampulla of Vater: carcinoid and adenocarcinoma].
  • [Transliterated title] Tumor de colisión periampular.
  • We report the case of a periampullary collision tumor, in which a duodenal-wall carcinoid and an adenocarcinoma of the head of the pancreas coexisted.
  • Solid cords and nests of neuroendocrine cells in the duodenal wall formed the carcinoid tumor, whereas the other neoplasm was made up of a well-differentiated adenocarcinoma of the pancreas.
  • [MeSH-major] Adenocarcinoma / pathology. Ampulla of Vater. Carcinoid Tumor / pathology. Common Bile Duct Neoplasms / pathology. Duodenal Neoplasms / pathology. Neoplasms, Multiple Primary / pathology. Pancreatic Neoplasms / pathology

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  • (PMID = 17590108.001).
  • [ISSN] 1130-0108
  • [Journal-full-title] Revista española de enfermedades digestivas : organo oficial de la Sociedad Española de Patología Digestiva
  • [ISO-abbreviation] Rev Esp Enferm Dig
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Spain
  • [Number-of-references] 15
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80. Fathy O, Abdel-Wahab M, Elghwalby N, Sultan A, El-Ebidy G, Abu-Zeid M, Abd-Allah T, El-Shobary M, Fouad A, Kandeel T, Abo-Elenien A, El-Hah NG, Abdel-Raouf A, Sultan AM, Ezzat F: Surgical management of peri-ampullary tumors: a retrospective study. Hepatogastroenterology; 2008 Jul-Aug;55(85):1463-9
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  • [Title] Surgical management of peri-ampullary tumors: a retrospective study.
  • The median survival was 22.6 months for patients with ampullary tumors and 16.6 months for patients with pancreatic head tumors.
  • Factors associated with better survival included tumor diameter (less than 3cm), origin (ampullary), differentiation (well differentiated) and margin status (negative resection margins).
  • Survival largely depends on the origin of the tumor.
  • [MeSH-major] Ampulla of Vater. Common Bile Duct Neoplasms / surgery. Duodenal Neoplasms / surgery. Pancreatic Ducts. Pancreatic Neoplasms / surgery. Pancreaticoduodenectomy

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  • (PMID = 18795713.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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81. Santini D, Vincenzi B, Perrone G, Rabitti C, Borzomati D, Valeri S, Coppola R, Magistrelli P, Tonini G: Vascular endothelial growth factor (VEGF) expression is not associated with prognosis in patients with radically resected ampullary carcinoma. Ann Oncol; 2005 Nov;16(11):1847-8
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  • [Title] Vascular endothelial growth factor (VEGF) expression is not associated with prognosis in patients with radically resected ampullary carcinoma.

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  • (PMID = 15972277.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Letter
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / VEGFA protein, human; 0 / Vascular Endothelial Growth Factor A
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82. Ohike N, Kim GE, Tajiri T, Krasinskas A, Basturk O, Coban I, Bandyopadhyay S, Morohoshi T, Goodman M, Kooby DA, Sarmiento JM, Adsay NV: Intra-ampullary papillary-tubular neoplasm (IAPN): characterization of tumoral intraepithelial neoplasia occurring within the ampulla: a clinicopathologic analysis of 82 cases. Am J Surg Pathol; 2010 Dec;34(12):1731-48
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  • [Title] Intra-ampullary papillary-tubular neoplasm (IAPN): characterization of tumoral intraepithelial neoplasia occurring within the ampulla: a clinicopathologic analysis of 82 cases.
  • BACKGROUND: There has been no uniform terminology for systematic analysis of mass-forming preinvasive neoplasms (which we term tumoral intraepithelial neoplasia) that occur specifically within the ampulla.
  • Here, we provide a detailed analysis of these neoplasms, which we propose to refer to as intra-ampullary papillary-tubular neoplasm (IAPN).
  • MATERIALS AND METHODS: Three hundred and seventeen glandular neoplasms involving the ampulla were identified through a review of 1469 pancreatoduodenectomies and 11 ampullectomies.
  • Eighty-two neoplasms characterized by substantial preinvasive exophytic component that grew almost exclusively (>75%) within the ampulla (in the ampullary channel or intra-ampullary portions of the very distal segments of the common bile duct or pancreatic duct) were analyzed. RESULTS:.
  • (1) Clinical: The mean age was 64 years, male/female ratio was 2.4, and mean tumor size was 2.7 cm. (2) Pathology: The tumors had a mixture of both papillary and tubular growth (each constituting at least 25% of the lesion) in 57%; predominantly (>75%) papillary in 23%, and predominantly (>75%) tubular in 20%.
  • Size of the tumor and amount of dysplasia correlated with the incidence of invasion.
  • When compared with 166 conventional invasive carcinomas of the ampullary region, invasive IAPNs had significantly better prognosis with a mean survival of 51 versus 31 months (P<0.001) and the 3-year survival of 69% versus 44% (P<0.01).
  • CONCLUSIONS: Tumoral intraepithelial neoplasia occurring within the ampulla are highly analogous to pancreatic or biliary intraductal papillary and tubular neoplasms as evidenced by their papillary and/or tubular growth, variable cell lineage, and spectrum of dysplastic change (adenoma-carcinoma sequence), and thus we propose to refer to these as IAPN.
  • IAPNs are biologically indolent; noninvasive examples show an excellent prognosis, whereas those with invasion exhibit a malignant but nevertheless significantly better prognosis than typical invasive ampullary carcinomas unaccompanied by IAPNs.
  • Twenty eight percent (64 of 230) of invasive carcinomas within the ampulla arise in association with IAPNs.

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  • (PMID = 21084962.001).
  • [ISSN] 1532-0979
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P20 CA101936; United States / NCI NIH HHS / CA / P50 CA062924; United States / NCI NIH HHS / CA / P50 CA062924-18; United States / NCI NIH HHS / CA / CA101936
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Other-IDs] NLM/ NIHMS315774; NLM/ PMC3168573
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83. Filippou DK, Pashalidis N, Skandalakis P, Rizos S: Malignant gastrointestinal stromal tumor of the ampulla of Vater presenting with obstructive jaundice. J Postgrad Med; 2006 Jul-Sep;52(3):204-6
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  • [Title] Malignant gastrointestinal stromal tumor of the ampulla of Vater presenting with obstructive jaundice.
  • Malignant gastrointestinal stromal tumor (GIST) consists a rare neoplasm, developing in small intestine and stomach.
  • The present case refers to a 65 years old female patient with a GIST of the ampulla of Vater presenting with obstructive jaundice.
  • Diagnosis was achieved pre-operatively by biopsies collected through diagnostic ERCP.
  • The tumour was locally excised, with preservation of the ampulla.
  • Malignant GIST of the ampulla of the Vater is extremely rare as only few similar cases have been described in the literature.
  • Despite the unavailability of EUS-FNA, the diagnosis was set preoperatively and the tumor was resected.
  • [MeSH-major] Ampulla of Vater. Gastrointestinal Stromal Tumors / complications. Jaundice, Obstructive / etiology
  • [MeSH-minor] Aged. Antigens, CD34 / analysis. Biomarkers, Tumor / analysis. Cholangiopancreatography, Endoscopic Retrograde. Disease-Free Survival. Female. Humans. Proto-Oncogene Proteins c-kit / analysis

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  • (PMID = 16855323.001).
  • [ISSN] 0022-3859
  • [Journal-full-title] Journal of postgraduate medicine
  • [ISO-abbreviation] J Postgrad Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] India
  • [Chemical-registry-number] 0 / Antigens, CD34; 0 / Biomarkers, Tumor; EC 2.7.10.1 / Proto-Oncogene Proteins c-kit
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84. Kamisawa T, Tu Y, Egawa N, Nakajima H, Horiguchi S, Tsuruta K, Okamoto A: Clinicopathologic features of ampullary carcinoma without jaundice. J Clin Gastroenterol; 2006 Feb;40(2):162-6
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  • [Title] Clinicopathologic features of ampullary carcinoma without jaundice.
  • GOALS: To evaluate clinicopathological features of ampullary carcinoma without jaundice.
  • BACKGROUND: : Obstructive jaundice is the most common symptom of patients with ampullary carcinoma.
  • However, some patients with ampullary carcinoma do not have jaundice at the time of diagnosis.
  • STUDY: Clinicopathologic findings of 23 patients with ampullary carcinoma showing no visible jaundice (serum total bilirubin <3.0 mg/dL) and 38 patients with ampullary carcinoma showing jaundice at the time of diagnosis were retrospectively compared.
  • RESULTS: Fifteen of 23 patients with nonjaundiced ampullary carcinoma complained of fever and/or abdominal pain.
  • Five asymptomatic patients were found to have a dilated bile duct on screening ultrasound or to have a tumor-like swelling of the papilla of Vater during routine upper gastrointestinal endoscopy.
  • Ten of the 23 nonjaundiced ampullary carcinomas (43%) were in Stage I, whereas 4 of the 38 jaundiced ampullary carcinomas (11%) were in Stage I (P < 0.01).
  • Mechanisms of nonjaundice in ampullary carcinoma were suspected to be determinant by the infiltrating pattern of the carcinoma to the lower portion of the bile duct.
  • CONCLUSIONS: Mechanisms of nonjaundice in ampullary carcinoma might be determined by the infiltrating pattern of the carcinoma to the lower portion of the bile.
  • As a greater number of nonjaundiced ampullary carcinomas were in an early stage, detection of them may provide an improved clinical outcome.
  • [MeSH-major] Ampulla of Vater / pathology. Common Bile Duct Neoplasms / pathology

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  • (PMID = 16394879.001).
  • [ISSN] 0192-0790
  • [Journal-full-title] Journal of clinical gastroenterology
  • [ISO-abbreviation] J. Clin. Gastroenterol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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85. Zhang XM, Shen CY, Li W, Zhang XM: [Surgical treatment of tumor invading important vessel]. Zhonghua Wai Ke Za Zhi; 2007 Aug 1;45(15):1044-7
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  • [Title] [Surgical treatment of tumor invading important vessel].
  • OBJECTIVE: To sum up preliminary experience of successful resection of tumor involving important vessel in 77 cases.
  • The tumor involving thoraco-abdominal cavity was in one case with malignant neuroblastoma.
  • The tumor from retro-peritoneum invaded into the whole inferior vena cava (IVC), and into two-thirds of the right atrium.
  • Tumor located in thoracic cavity were in 13 cases including IVC leiomyosarcoma in 2 cases, thymic carcinoma in 3 cases, malignant thymoma in 4 cases, malignant seminoma of superior mediastinum in 1 case, malignant lymphoma in 1 case, lung cancer in 2 cases.
  • The tumor located in abdominal cavity were in 24 cases including renal carcinoma with tumor thrombi in 11 cases, inflammatory pseudotumor of retro-peritoneum in 4 cases, malignant fibrous histiocytoma of retro-peritoneum in 1 case, non-Hodgkin's disease of retro-peritoneum in 1 case, lymph metastasis of retro-peritoneum in 2 cases, paraganglion tumor of the right adrenal gland in 1 case, ampullary carcinoma in 1 case, leiomyosarcoma of abdominal IVC in 1 case, leiomyosarcoma of pelvic cavity and IVC in 1 cases, fibrosarcoma of pelvic cavity in 1 case.
  • Tumor located in four extremities in 6 cases including osteogenic sarcoma in 3 cases, vascular endotheliosarcoma of the left iliac fossa in 1 case, neurofibroma of the left upper extremity in 1 case, lymphoma of double groin in 1 case.
  • Tumor located in neck in 33 cases including carotid body tumor in 32 cases and neurofibroma of the left upper extremity in 1 case.
  • RESULTS: Complete resection of tumor was in 72 cases, with a rate of 93.5%, palliative resection of tumor was in 5 cases with a rate of 6.5%.
  • Temporary shunt of carotid artery for neck tumor was used in 18 cases.
  • No death occurred for benign tumor.
  • CONCLUSION: The radical resection rate for tumor involving important vessel may be improved with the help of vascular technique.
  • [MeSH-minor] Adolescent. Adult. Aged. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Invasiveness. Retrospective Studies. Treatment Outcome. Vena Cava, Inferior / pathology. Vena Cava, Inferior / surgery

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  • (PMID = 18005586.001).
  • [ISSN] 0529-5815
  • [Journal-full-title] Zhonghua wai ke za zhi [Chinese journal of surgery]
  • [ISO-abbreviation] Zhonghua Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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86. Gleisner AL, Assumpcao L, Cameron JL, Wolfgang CL, Choti MA, Herman JM, Schulick RD, Pawlik TM: Is resection of periampullary or pancreatic adenocarcinoma with synchronous hepatic metastasis justified? Cancer; 2007 Dec 1;110(11):2484-92
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  • BACKGROUND: To date, no consensus has been reached regarding which primary tumor subtypes are managed appropriately with hepatic metastectomy.
  • Data on demographics, operative details, primary tumor status, and-when indicated-extent of hepatic metastasis were collected.
  • The primary tumor site was ampullary (n=1 patient ), duodenal (n=2 patients), distal bile duct (n=2 patients), or pancreas (head, n=10 patients; tail, n=7 patients).
  • After matching patients on primary tumor histology and location, the median survival of patients who underwent hepatic resection of synchronous metastasis was 5.9 months compared with 5.6 months for patients who underwent palliative bypass alone (P=.46) and 14.2 months for patients with no metastatic disease who underwent primary tumor resection only (P<.001).
  • Pancreatic (median, 5.9 months) versus nonpancreatic (median, 9.9 months) primary tumor histology was not associated with a difference in survival in patients who underwent resection of synchronous liver metastasis (P=.43).

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  • [Copyright] Copyright (c) 2007 American Cancer Society.
  • (PMID = 17941009.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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87. Kalogeraki A, Tzardi M, Papadakis M, Stathopoulos E, Kouroumalis E, Zoras O: Apoptosis and cell proliferation correlated with tumor grade in patients with ampullary carcinoma. Acta Cytol; 2010 Jan-Feb;54(1):39-42
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  • [Title] Apoptosis and cell proliferation correlated with tumor grade in patients with ampullary carcinoma.
  • STUDY DESIGN: Forty patients (23 males and 17 females) aged 45-81 who underwent endoscopic retrograde cholangiopancreatography were diagnosed by cytology as having ampullary adenocarcinoma and the diagnoses were confirmed histologically after an operation.
  • RESULTS: The TUNEL indices were 0.4 +/- 0.07, 0.91 +/- 0.33 and 3.1 +/- 0.9 in well, moderate and poorly differentiated ampullary carcinoma, respectively.
  • The differences in both TUNEL and MIB-1 labeling indices were statistically significant between well, moderately and poorly differentiated ampullary carcinoma, and a positive correlation was found between TUNEL and the MIB-1 indices.
  • CONCLUSION: Apoptosis (cell death) and cell proliferation increase as the grade of the differentiation decreases in ampullary carcinoma, suggesting a rapid turnover of the tumor cells with lower grates of differentiation, and apoptosis may play an important role in the growth of the tumors in patients with ampullary carcinomas.
  • [MeSH-major] Adenocarcinoma / pathology. Ampulla of Vater / pathology. Apoptosis. Cell Proliferation. Common Bile Duct Neoplasms / pathology
  • [MeSH-minor] Aged. Aged, 80 and over. Antibodies, Antinuclear / analysis. Antibodies, Monoclonal / analysis. DNA Fragmentation. Female. Humans. Immunohistochemistry. In Situ Nick-End Labeling. Male. Middle Aged. Neoplasm Staging. Prognosis

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  • (PMID = 20306986.001).
  • [ISSN] 0001-5547
  • [Journal-full-title] Acta cytologica
  • [ISO-abbreviation] Acta Cytol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Antinuclear; 0 / Antibodies, Monoclonal; 0 / MIB-1 antibody
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88. Krishnan S, Rana V, Evans DB, Varadhachary G, Das P, Bhatia S, Delclos ME, Janjan NA, Wolff RA, Crane CH, Pisters PW: Role of adjuvant chemoradiation therapy in adenocarcinomas of the ampulla of vater. Int J Radiat Oncol Biol Phys; 2008 Mar 1;70(3):735-43
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  • [Title] Role of adjuvant chemoradiation therapy in adenocarcinomas of the ampulla of vater.
  • PURPOSE: The role of adjuvant chemoradiation therapy (CRT) in the treatment of ampullary cancers remains undefined.
  • METHODS AND MATERIALS: Between May 1990 and January 2006, 54 of 96 patients with ampullary adenocarcinoma who underwent potentially curative pancreaticoduodenectomy also received adjuvant CRT.
  • On univariate analysis, age, gender, race/ethnicity, tumor grade, use of adjuvant treatment, and sequencing of adjuvant therapy were not significantly associated with LC, DC, or OS.
  • However, on univariate analysis, T3/T4 tumor stage was prognostic for poorer LC and OS (p = 0.02 and p < 0.001, respectively); node-positive disease was prognostic for poorer LC (p = 0.03).
  • On multivariate analysis, T3/T4 tumor stage was independently prognostic for decreased OS (p = 0.002).
  • CONCLUSIONS: Ampullary cancers have a distinctly better treatment outcome than pancreatic adenocarcinomas.
  • Higher primary tumor stage (T3/T4), an independent adverse risk factor for poorer treatment outcomes, may warrant the addition of adjuvant CRT to pancreaticoduodenectomy.
  • [MeSH-major] Ampulla of Vater. Common Bile Duct Neoplasms / drug therapy. Common Bile Duct Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Analysis of Variance. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Capecitabine. Chemotherapy, Adjuvant. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Female. Fluorouracil / administration & dosage. Fluorouracil / analogs & derivatives. Humans. Male. Middle Aged. Neoplasm Staging. Pancreaticoduodenectomy. Prognosis. Radiotherapy Dosage. Radiotherapy, Adjuvant. Retrospective Studies

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  • (PMID = 17980502.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; 6804DJ8Z9U / Capecitabine; U3P01618RT / Fluorouracil
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89. Georgescu SO, Neacşu CN, Vintilă D, Popa P, Florea N, Mihailovici MS: The histopathologic type of the periampullary tumors. Is it important for survival? Chirurgia (Bucur); 2009 Nov-Dec;104(6):697-700
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  • BACKGROUND: The ampulla of Vater is a junction with four histologic epithelial types: ampullary, duodenal, pancreatic and biliary.
  • Using our database we assessed the overall survival based on histologic type, tumor stage, lymph nodes involvement, tumor size and the level of differentiation.
  • [MeSH-major] Adenocarcinoma / mortality. Adenocarcinoma / pathology. Ampulla of Vater. Duodenal Neoplasms / mortality. Duodenal Neoplasms / pathology. Pancreatic Neoplasms / mortality. Pancreatic Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Female. Humans. Lymphatic Metastasis. Male. Medical Records. Middle Aged. Multivariate Analysis. Neoplasm Staging. Pancreaticoduodenectomy / mortality. Prognosis. Proportional Hazards Models. Retrospective Studies. Romania / epidemiology. Survival Analysis. Treatment Outcome


90. Okabayashi T, Kobayashi M, Nishimori I, Sugimoto T, Akimori T, Namikawa T, Okamoto K, Onishi S, Araki K: Benefits of early postoperative jejunal feeding in patients undergoing duodenohemipancreatectomy. World J Gastroenterol; 2006 Jan 7;12(1):89-93
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  • METHODS: We studied 39 patients who underwent DHP for a peri-ampullary mass.
  • CONCLUSION: EPEN is a safe and beneficial opportunity for patients who have undergone DHP for a peri-ampullary mass.

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  • (PMID = 16440423.001).
  • [ISSN] 1007-9327
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Serum Albumin
  • [Other-IDs] NLM/ PMC4077486
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91. Bettini R, Falconi M, Crippa S, Capelli P, Boninsegna L, Pederzoli P: Ampullary somatostatinomas and jejunal gastrointestinal stromal tumor in a patient with Von Recklinghausen's disease. World J Gastroenterol; 2007 May 21;13(19):2761-3
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  • [Title] Ampullary somatostatinomas and jejunal gastrointestinal stromal tumor in a patient with Von Recklinghausen's disease.
  • We report a case of a 47-year-old Caucasian male affected by Von Recklinghausen's disease who developed a malignant somatostatinoma of the papilla major and minor associated with jejunal gastrointestinal stromal tumour with uncertain behaviour.
  • This is the fourth case reported in the world literature of a patient with Von Recklinghausen's disease associated with periampullary somatostatinomas and jejunal stromal tumor.
  • In patients with Von Recklinghausen's disease who complain of gastrointestinal symptoms, a high suspicion index for periampullary endocrine tumours and/or gastrointestinal stromal tumour is required.
  • [MeSH-major] Ampulla of Vater / pathology. Common Bile Duct Neoplasms / etiology. Gastrointestinal Stromal Tumors / etiology. Jejunal Neoplasms / etiology. Neurofibromatosis 1 / complications. Somatostatinoma / etiology

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  • (PMID = 17569151.001).
  • [ISSN] 1007-9327
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
  • [Other-IDs] NLM/ PMC4147131
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92. Mavroudis N, Rafailidis S, Symeonidis N, Aimoniotou E, Antonopoulos V, Evgenidis N, Venizelos L, Sakadamis A: Carcinoid of the ampulla of Vater--report of two cases. Acta Chir Belg; 2005 Apr;105(2):213-6
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  • [Title] Carcinoid of the ampulla of Vater--report of two cases.
  • Carcinoid of the ampulla of Vater is extremely rare, accounting for less than 0.3% of all gastro-intestinal carcinoids.
  • To our knowledge, only 80 cases of ampullary carcinoid have been reported in the literature to date.
  • Ampullary carcinoid is more commonly presented with jaundice or upper abdominal discomfort and diagnosis is more often made postoperatively due to submucosal spread of the tumour.
  • As metastatic potential cannot be predicted by tumour size, Whipple pancreatoduodenectomy rather than local excision is considered to be the treatment of choice.
  • We report here two cases of ampullary carcinoid treated in our department.
  • [MeSH-major] Ampulla of Vater. Carcinoid Tumor / diagnosis. Carcinoid Tumor / surgery. Common Bile Duct Neoplasms / diagnosis. Common Bile Duct Neoplasms / surgery
  • [MeSH-minor] Biopsy, Needle. Female. Follow-Up Studies. Humans. Immunohistochemistry. Male. Middle Aged. Neoplasm Staging. Pancreaticoduodenectomy / methods. Risk Assessment. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 15906919.001).
  • [ISSN] 0001-5458
  • [Journal-full-title] Acta chirurgica Belgica
  • [ISO-abbreviation] Acta Chir. Belg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Belgium
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93. Qiao QL, Zhao YG, Ye ML, Yang YM, Zhao JX, Huang YT, Wan YL: Carcinoma of the ampulla of Vater: factors influencing long-term survival of 127 patients with resection. World J Surg; 2007 Jan;31(1):137-43; discussion 144-6
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  • [Title] Carcinoma of the ampulla of Vater: factors influencing long-term survival of 127 patients with resection.
  • INTRODUCTION: The prognosis for patients with carcinoma of the ampulla of Vater is improved relative to other periampullary neoplasms.
  • Identification of independent prognostic factors in ampullary carcinomas has been limited by the small number of tumors resected.
  • The aim of the present study was to determine the clinicopathologic factors that influence long-term survival in patients with resected ampullary carcinoma.
  • METHODS: Clinicopathologic data were retrospectively reviewed for patients with ampullary carcinomas radically resected between March 1987 and September 2002.
  • Ampullary carcinomas were radically resected in 127 patients either by pancreaticoduodenectomy (n = 124) or local resection (n = 3).
  • Factors that significantly influenced survival were lymph node status (P < 0.001), depth of tumor infiltration (P = 0.029), and TNM stage (P < 0.001) on univariate analysis.
  • CONCLUSIONS: Carcinoma of the ampulla of Vater has a higher resectability rate and a much better survival rate than pancreatic cancer.
  • Pancreaticoduodenectomy is the treatment of choice for this tumor.
  • Long-term survival was independently influenced by the depth of tumor infiltration and lymph node metastasis.
  • [MeSH-major] Adenocarcinoma / mortality. Adenocarcinoma / surgery. Ampulla of Vater. Common Bile Duct Neoplasms / mortality. Common Bile Duct Neoplasms / surgery. Pancreaticoduodenectomy
  • [MeSH-minor] Adolescent. Adult. Aged. Female. Hospital Mortality. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Invasiveness. Proportional Hazards Models. Retrospective Studies. Survival Analysis

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  • (PMID = 17171495.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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94. Schirmacher P, Büchler MW: Ampullary adenocarcinoma - differentiation matters. BMC Cancer; 2008;8:251
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  • [Title] Ampullary adenocarcinoma - differentiation matters.
  • This fuels the discussion about maintaining ampullary cancer as a separate entity.
  • [MeSH-major] Adenocarcinoma / diagnosis. Ampulla of Vater / pathology. Common Bile Duct Neoplasms / diagnosis
  • [MeSH-minor] Biomarkers, Tumor. Cell Differentiation. Diagnosis, Differential. Epithelium / pathology. Humans. Medical Oncology / methods. Prognosis

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  • (PMID = 18761739.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Editorial
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Other-IDs] NLM/ PMC2553420
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95. Paláu MA, Merino MJ, Quezado M: Corticotropin-producing pulmonary gangliocytic paraganglioma associated with Cushing's syndrome. Hum Pathol; 2006 May;37(5):623-6
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  • Gangliocytic paraganglioma (GP) is an unusual tumor in the wide spectrum of neuroendocrine neoplasms.
  • The biologic behavior and histogenesis of this tumor is uncertain because, despite its benign histologic features, there have been reports of metastases to regional lymph nodes and distant metastases.
  • Although most of these tumors have been reported in the duodenum, examples of GP arising in extra-ampullary sites have been well documented.
  • After removal of the tumor, there was a significant drop in cortisol and corticotropin levels.


96. de Paiva Haddad LB, Patzina RA, Penteado S, Montagnini AL, da Cunha JE, Machado MC, Jukemura J: Lymph node involvement and not the histophatologic subtype is correlated with outcome after resection of adenocarcinoma of the ampulla of vater. J Gastrointest Surg; 2010 Apr;14(4):719-28
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  • [Title] Lymph node involvement and not the histophatologic subtype is correlated with outcome after resection of adenocarcinoma of the ampulla of vater.
  • BACKGROUND: Intestinal and pancreaticobiliary types of Vater's ampulla adenocarcinoma have been considered as having different biologic behavior and prognosis.
  • The aim of the present study was to determine the best immunohistochemical panel for tumor classification and to analyze the survival of patients having these histological types of adenocarcinoma.
  • METHOD: Ninety-seven resected ampullary adenocarcinomas were histologically classified, and the prognosis factors were analyzed.
  • RESULTS: Forty-three Vater's ampulla carcinomas were histologically classified as intestinal type, 47 as pancreaticobiliary, and seven as other types.
  • CONCLUSION: The immunohistochemical expression of CDX2, MUC1, and MUC2 allows a reproducible classification of ampullary carcinomas.
  • [MeSH-major] Adenocarcinoma / pathology. Ampulla of Vater / pathology. Common Bile Duct Neoplasms / pathology. Lymphatic Metastasis / pathology

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  • (PMID = 20107918.001).
  • [ISSN] 1873-4626
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / CDX2 Transcription Factor; 0 / CDX2 protein, human; 0 / Homeodomain Proteins; 0 / MUC1 protein, human; 0 / MUC2 protein, human; 0 / Mucin-1; 0 / Mucin-2
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97. Casaretto E, Andrada DG, Granero LE: [Results of cephalic pancreaticoduodenectomy for ampullary carcinoma. Analysis of 18 consecutive cases]. Acta Gastroenterol Latinoam; 2010 Mar;40(1):22-31
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  • [Title] [Results of cephalic pancreaticoduodenectomy for ampullary carcinoma. Analysis of 18 consecutive cases].
  • [Transliterated title] Resultados de la duodenopancreatectomía cefálica en el tratamiento del carcinoma de la ampolla de vater. Análisis de 18 casos consecutivos.
  • BACKGROUND: Complete resection offers the only potential cure for ampullary carcinoma.
  • AIM: The aim of this study was to assess the results of cephalic pancreaticoduodenectomy for patients with ampullary carcinoma based on mortality, hospital morbidity, late morbidity, and survival.
  • PATIENTS AND METHODS: We retrospectively and prospectively reviewed all patients who underwent cephalic pancreaticoduodenectomy, between October 1994 and October 2006 for ampullary carcinoma.
  • The tumor was unresectable in the remaining 2 patients.
  • Resection margins were tumor free (RO) in all patients.
  • CONCLUSIONS: Cephalic pancreaticoduodenectomy is the surgical procedure of choice for ampullary carcinoma, with low hospital mortality, and the best chance for cure in patients with node-negative disease.
  • [MeSH-major] Ampulla of Vater. Carcinoma / surgery. Common Bile Duct Neoplasms / surgery. Pancreaticoduodenectomy
  • [MeSH-minor] Adult. Aged. Female. Humans. Kaplan-Meier Estimate. Male. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Prospective Studies. Retrospective Studies. Treatment Failure

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  • (PMID = 20446393.001).
  • [ISSN] 0300-9033
  • [Journal-full-title] Acta gastroenterologica Latinoamericana
  • [ISO-abbreviation] Acta Gastroenterol. Latinoam.
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Argentina
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98. Genc H, Haciyanli M, Tavusbay C, Colakoglu O, Aksöz K, Unsal B, Ekinci N: Carcinoma arising from villous adenoma of the ampullary bile duct: Report of a case. Surg Today; 2007;37(2):165-8
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  • [Title] Carcinoma arising from villous adenoma of the ampullary bile duct: Report of a case.
  • Adenocarcinoma arising from the villous adenoma of the ampullary biliary epithelium is an extremely rare disorder.
  • The preoperative diagnosis and treatment of the disease represent a major difficulty.
  • Next, a transduodenal resection of ampulla and reconstruction were performed.
  • The surgical margins were tumor free.
  • This case shows the importance of surgeons to keep in mind the fact that frozen examinations may sometimes miss a malignancy and they therefore cannot be relied upon to rule out malignancy in villous adenoma of the ampullary bile duct.
  • [MeSH-major] Adenocarcinoma / diagnosis. Adenoma, Villous / diagnosis. Ampulla of Vater. Common Bile Duct Neoplasms / diagnosis. Neoplasms, Multiple Primary
  • [MeSH-minor] Aged. Cholangiopancreatography, Endoscopic Retrograde. Cholecystectomy. Diagnosis, Differential. Duodenoscopy. Female. Follow-Up Studies. Humans

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  • (PMID = 17243040.001).
  • [ISSN] 0941-1291
  • [Journal-full-title] Surgery today
  • [ISO-abbreviation] Surg. Today
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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99. Hsu HP, Shan YS, Jin YT, Lai MD, Lin PW: Loss of E-cadherin and beta-catenin is correlated with poor prognosis of ampullary neoplasms. J Surg Oncol; 2010 Apr 1;101(5):356-62
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  • [Title] Loss of E-cadherin and beta-catenin is correlated with poor prognosis of ampullary neoplasms.
  • BACKGROUND AND OBJECTIVES: Distant metastasis resulting from carcinoma cell detachment from the primary tumor involves modification of adhesion molecules.
  • This study was conducted to examine the correlation of E-cadherin/beta-catenin expression with survival and recurrence in ampullary neoplasms.
  • METHODS: Patients with diagnoses of ampullary neoplasms were enrolled in the study.
  • Loss of beta-catenin expression was associated with tumor markers, ulcerative type, liver metastases, and poor prognosis.
  • CONCLUSIONS: Loss of the E-cadherin/beta-catenin complex is related to poor prognosis in ampullary cancer.
  • [MeSH-major] Ampulla of Vater. Cadherins / analysis. Common Bile Duct Neoplasms / chemistry. Common Bile Duct Neoplasms / mortality. beta Catenin / analysis
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Prognosis

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  • [Copyright] (c) 2010 Wiley-Liss, Inc.
  • (PMID = 20119975.001).
  • [ISSN] 1096-9098
  • [Journal-full-title] Journal of surgical oncology
  • [ISO-abbreviation] J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Cadherins; 0 / beta Catenin
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100. Defrain C, Chang CY, Srikureja W, Nguyen PT, Gu M: Cytologic features and diagnostic pitfalls of primary ampullary tumors by endoscopic ultrasound-guided fine-needle aspiration biopsy. Cancer; 2005 Oct 25;105(5):289-97
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  • [Title] Cytologic features and diagnostic pitfalls of primary ampullary tumors by endoscopic ultrasound-guided fine-needle aspiration biopsy.
  • BACKGROUND: Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-guided FNAB) is highly sensitive and specific in cytologic diagnosis and clinical staging of malignant neoplasms of the gastrointestinal tract, pancreas, liver, and lymph nodes.
  • However, no study has been performed to evaluate its accuracy, sensitivity, specificity, and the cytomorphologic features of suspected primary ampullary tumors.
  • METHODS: All EUS-guided FNABs of suspected primary ampullary lesions at the University of California Irvine Medical Center (Orange, CA) from January 1998 to September 2004 were retrospectively retrieved.
  • The number of passes necessary to arrive at a preliminary diagnosis during adequacy assessment was documented.
  • Adenoma was diagnosed in two patients and carcinoid tumor in one.
  • Thirteen patients had a diagnosis that was negative for malignant cells.
  • CONCLUSIONS: EUS-guided FNAB was accurate, sensitive, and specific in the assessment of suspected primary ampullary masses.
  • [MeSH-major] Adenocarcinoma / diagnosis. Adenocarcinoma / pathology. Adenoma / diagnosis. Adenoma / pathology. Ampulla of Vater / pathology. Common Bile Duct Neoplasms / diagnosis. Common Bile Duct Neoplasms / pathology

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  • (PMID = 15986397.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
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