A Case of Signet-ring Cell Carcinoma of the Ampulla of Vater

Naohito Kanazumi, Aya Motoyama, Daisuke Kobayashi, Yasuaki Kanyama, Kazuki Yokoi, Yuichi Suzuki, Jiro Kimura and Masataka Ishii

Department of Surgery, Okazaki City Hospital

We report a rare case of signet-ring cell carcinoma of the ampulla of Vater. A 59-year-old man admitted for further examination of liver function disorder in a blood chemistry test done due to a fever and appetite loss was found in abdominal ultrasonography (US) and computed tomography (CT) to have a dilated intrahepatic bile duct, common bile duct, and main pancreatic duct. At duodenoscopy, the papilla of Vater was reddish and enlarged with a small ulcer, and biopsy specimens from the papilla demonstrated signet-ring cell carcinoma. We conducted pylorus-preserving pancreatoduodenectomy based on a diagnosis of signet-ring cell carcinoma of the ampulla of Vater. The tumor was 2×3 cm, ulcerated, and protruding. Histopathological findings showed signet-ring cell carcinoma occupied the ampulla of Vater and lymph node metastasis was found within group 1 nodes. The patient is doing well and has no recurrence 1 year and 8 months after surgery. Signet-ring cell carcinoma of the ampulla of Vater is rare, with our case being only the 16th reported in the literature.

Key words
signet-ring cell carcinoma, ampulla of Vater, carcinoma of the papilla of Vater

Reprint requests
Naohito Kanazumi Department of Surgery, Okazaki City Hospital
3-1 Goshoai, Koryuji-cho, Okazaki, 444-8553 JAPAN

Accepted
November 26, 2003

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