27months Recurrence-free Survival Case of Endcrine Cell Carcinoma of the Ampullary of Vater after Adjvant Chemotherapy

Daisuke Saikawa, Taku Hashimoto, Hironori Kasai, Yasuhiro Tani, Tomonori Nakagawa and Tomoyuki Takagi

Department of Surgery, Wakkanai City Hospital

Neuroendocrine carcinoma of the ampulla of Vater is very aggressive and has a dismal prognosis, but no consensus has been reached on multimodality therapy. We report such a case indicating the possible positive effect of adjuvant chemotherapy. A 71-year-old woman seen for jaundice and fatigue was diagnosed with endocrine cell carcinoma of the ampulla of Vater, necessitating pancreatoduodenectomy with regional lymph node dissection. Resected specimens showed minimal invasion of pancreatic tissue by the tumor and lymph node metastasis at the inferior pancreaticoduodenal artery root. Histologically, the tumor showed sheets of small round cells with hyperchromatic nuclei and scanty cytoplasm. Immunohistochemically, positive staining was seen for CAM5.2, chromogranin A, and NSE. Adjuvant chemotherapy with CDDP/CPT-11 or CDDP/VP-16 conducted based on small-cell lung carcinoma chemotherapy yield 27 months of postoperative recurrence-free survival. This case thus shows the possibility that adjuvant chemotherapy can be effective in treating advanced neuroendocrine carcinoma of the ampulla of Vater.

Key words
neuroendocrine carcinoma, ampulla of Vater, adjuvant chemotherapy

Reprint requests
Daisuke Saikawa Department of Surgery, Wakkanai City Hospital
4-11-6 Chuo, Wakkanai, Hokkaido, 097-8555 JAPAN

Accepted
May 19, 2010

To read the PDF file you will need Abobe Reader installed on your computer.