A Case of Coexisiting Adenocarcinoma in the Papilla of Vater and Carcinoid Tumor in the Accessory Papilla

Johta Watanabe, Takashi Nishizaki, Kenzo Wakasugi, Ikuo Takahashi, Toshihiro Onohara, Tetsuo Ishikawa, Toshimitsu Matsuzaka, Kazuhiro Kume and Ichiro Yamamoto*

Department of surgery and pathology*, Matsuyama Red Cross Hospital, Ehime Japan

A 66-year-old woman complained of epigastralgia about one month prior to consulting our clinic. Endoscopic examination revealed a tumor about 10 mm in diameter in the ampulla of Vater. A biopsy specimen revealed adenocarcinoma, and pancreatoduodenectomy was performed. The resected specimen showed well differentiated adenocarcinoma of the papilla of Vater and another tumor 4 mm in diameter in the accessory papilla. In the immunohistochemical analyses, the cytoplasm of the cells in the tumor in the accessory papilla stained positive staining for neuron specific enolase (NSE) and chromogranin-A (CgA). The diagnosis was carcinoid. At the 30-month follow-up examination the patient was doing well with no evidence of recurrence of either the carcinoma or the carcinoid. To the best of our knowledge, this is the first case in the literature of concomitant adenocarcinoma of the papilla of Vater and carcinoid tumor of the accessory duodenal papilla.

Key words
carcinoma of papilla of vater, carcinoid tumor, accessory papilla

Reprint requests
Jota Watanabe Department of surgery, Matsuyama Red Cross Hospital, 1 bunkyo-tyo Matsuyama-city, 790-0826 JAPAN

Accepted
December 22, 1999

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