case report: ampullary adenocarcinoma primary presentation by fever, chills and anemia

ampullary tumor is a rare cancer. these patients most commonly present with obstructive jaundice but sometimes disease appear with uncommon signs. this report is an example of such cases. our case is a 53 year old man who presented with recurrent fever and chills and iron deficiency anemia and has been misdiagnosed for two years. the proper diagnosis occurred when the patient showed abnormal liver function tests and more evaluation with endoscopic ultrasonography detected a mass in distal part of common bile duct then pathology confirmed our diagnosis. despites that jaundice is most prevalent symptom in patients with an ampullary tumor but sometimes disease appear with rare signs such as iron deficiency anemia.