Neuroendocrine Carcinoma with an Adenocarcinoma Component on the Ampulla of Vater Causing Acute Pancreatitis: A Case Report

نویسندگان

  • Reiko Yamada
  • Kenichiro Nishikawa
  • Masashi Kishiwada
  • Hiroyuki Inoue
  • Takashi Sakuno
  • Tetsuro Harada
  • Naohiko Yoshizawa
  • Shinichi Kojima
  • Hiroshi Miura
  • Misaki Nakamura
  • Masaki Katsurahara
  • Yasuhiko Hamada
  • Kyosuke Tanaka
  • Noriyuki Horiki
  • Yoshiyuki Takei
  • Shuji Isaji
چکیده

We encountered a rare case in which a 14 mm ampullary tumor had both components of neuroendocrine carcinoma and adenocarcinoma, which caused acute pancreatitis. A Sixty-one-year-old woman was referred to our hospital for evaluation and treatment of pancreatitis due to an unknown cause. After various imaging examinations, the cause of pancreatitis was found to be a duodenal papillary tumor. We performed endoscopic retrograde pancreatic duct drainage by inserting a drainage tube; subsequently, her abdominal pain was relieved, and the pancreatic enzyme levels normalized. As the pathological findings showed poorly differentiated neuroendocrine carcinoma, pancreaticoduodenectomy was performed. As liver and lymph node metastases were found 3 months postoperatively, she underwent chemotherapy. Although she achieved complete remission once, metastases relapsed and she died of progressive disease 28 months postoperatively. Histological examination showed that the tumor comprised two elements: the main component (99.5%) was neuroendocrine carcinoma, and the minor component was adenocarcinoma. The adenocarcinoma component was observed only in the mucosal layer, whereas the neuroendocrine component invaded the submucosa or deeper layer. It is speculated that adenocarcinoma had arisen first from the epithelium, and then it acquired neuroendocrine differentiation capabilities during growth. Although some reports have proposed that neuroendocrine components have more aggressive features than adenocarcinoma components, it is still unclear whether the neuroendocrine or adenocarcinoma component is the main driving force of disease progression. Neuroendocrine carcinoma with an adenocarcinoma component is highly aggressive and associated with a high risk for distant metastasis and a poor prognosis, as in the present case. Received March 25th, 2017-Accepted April 26th, 2017

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Collision tumor of the ampulla of Vater - Coexistence of neuroendocrine carcinoma and adenocarcinoma: report of a case

Herein, we present a case of coexisting neuroendocrine carcinoma and conventional adenocarcinoma (collision tumor) in the ampulla of Vater, which has seldom been reported in the literature. A 51-year-old man presented with a month history of jaundice. MRCP disclosed about 1.9×1.8 cm sized heterogeneously enhancing mass in ampulla of Vater, causing obstructions of distal common bile duct. He und...

متن کامل

Acute recurrent pancreatitis: a possible clinical manifestation of ampullary cancer.

CONTEXT Acute recurrent pancreatitis still poses diagnostic difficulties. The coexistence or moreover the causative relationship of carcinoma of the ampulla of Vater and acute recurrent pancreatitis is fairly rare. CASE REPORT We present a case of carcinoma of the ampulla of Vater that presented with acute recurrent necrotizing pancreatitis complicated with pseudocysts. A diagnosis of maligna...

متن کامل

Recurrent acute pancreatitis in a patient with wirsungocele and neuroendocrine tumor of ampulla of Vater.

CONTEXT Wirsungocele has recently been shown to be associated with acute recurrent, severe necrotizing pancreatitis and chronic pancreatitis or chronic pain in abdomen. Till to date there is no report on association of wirsungocele with an ampullary neuroendocrine tumor, and recurrent pancreatitis. CASE REPORT We report a first ever case of wirsungocele diagnosed on EUS, its association with ...

متن کامل

Coexistence of large cell neuroendocrine carcinoma and adenocarcinoma of the ampulla of vater.

We report a case of coexisting poorly differentiated endocrine carcinoma and conventional adenocarcinoma in the ampulla of Vater. A 70-year-old female had a recent history of symptoms and signs related to obstructive jaundice. An initial endoscopic biopsy of the ampulla of Vater showed a poorly differentiated endocrine carcinoma in the lamina propria of duodenal mucosa. The tumor could also be ...

متن کامل

Report of two cases of large cell neuroendocrine carcinoma of duodenal ampulla with contrasting outcomes following pancreaticoduodenectomy according to the use of adjuvant chemotherapy

INTRODUCTION Large-cell neuroendocrine carcinoma (LCNEC) in the duodenal ampulla of Vater is a rare malignant tumor, with frequent postoperative recurrence and poor prognosis even following complete resection. Effective adjuvant chemotherapy is expected to offer longer survival. PRESENTATION OF CASE We present two patients with LCNEC accompanied by components of tubular adenocarcinoma/adenoma...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره   شماره 

صفحات  -

تاریخ انتشار 2017