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Tumors of ampulla of Vater: A case series and review of chemotherapy options

World Journal of Gastrointestinal Oncology 2012年第3期4卷 60-67页

作者： Adriana Romiti viola barucca Angelo Zullo Ida Sarcina Roberta Di Rocco Chiara D'Antonio Marco Latorre Paolo Marchetti Oncology Unit University "La Sapienza" Sant'Andrea Hospital via di Grottarossa 1035 00189 Rome Italy Gastroenterology and Digestive Endoscopy "Nuovo Regina Margherita" Hospital via Morosini 30 00185 Rome Italy Department of General Surgery University "La Sapienza" Sant'Andrea Hospital via di Grottarossa 1035 00189 Rome Italy

Carcinomas of the Ampulla of Vater are rare tumors, accounting for 0.2% of gastrointestinal cancers. Compared with other biliary tract neoplasms, these tumors have a relatively favorable prognosis after surgical resection. Based on their epithelium of origin, two subtypes of ampullary carcinoma have been recently distinguished: intestinal and pancreatobiliary. This study evaluates histopathological features and outcomes of ampullary carcinoma and to compares the survival of these tumors to that of other biliary tract tumors. The chemotherapic options available for ampullary cancer are also reviewed. We analyzed data from 20 consecutive patients with ampullary carcinomas and 26 patients with other biliary tract carcinomas, observed in our Institution. Statistical analysis was performed by using either Fisher's exact test or χ2 test for categorical variables. Median time of survival was calculated and compared using the Log-Rank test. Similar distribution of demographic characteristics and stage between ampullary and other biliary tract cancers was observed. Patients with ampullary cancer underwent surgery more frequently than other biliary cancers while chemotherapy and radiotherapy were used equally. In accordance with the literature, a longer median survival was observed in the group of ampullary carcinomas.

关键词： Ampullary carcinoma Chemotherapy Radiotherapy Biliary tract cancer

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Simultaneous intraductal papillary neoplasms of the bile duct and pancreas treated with chemoradiotherapy

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World Journal of Gastrointestinal Oncology 2012年第2期4卷 22-25页

作者： Roberto Valente Gabriele Capurso Paola Pierantognetti Elsa Iannicelli Matteo Piciucchi Adriana Romiti Paolo Mercantini Alberto Larghi Giulia Francesca Federici viola barucca Maria Falchetto Osti Emilio Di Giulio Vincenzo Ziparo Gianfranco Delle Fave Digestive and Liver Disease Unit Second Medical School"La Sapienza" UniversityS. An-drea Hospital00189 RomeItaly Nursery Science Second Medical School "La Sapienza" University00189 RomeItaly Radiology Unit "La Sapienza" University00189 RomeItaly Oncology Unit "La Sapienza" University00189 RomeItaly General Surgery Unit "La Sapienza" University00189 RomeItaly Digestive Endoscopy Unit Catholic University000192 RomeItaly Radiotheraphy Unit "La Sapienza" Uni-versity00189 RomeItaly

Some authors have suggested that intraductal papillary mucinous neoplasms of the bile duct(IPMN-B) could be the the biliary counterpart of IPMN of the pancreas(IPMN-P) since they share several clinical-pathological *** include prominent intraductal papil-lary proliferation pattern,a gastrointestinal phenotype,frequent mucin hyper-secretion and progression to mu-cinous *** date there are just four reported cases of patients with synchronous IPMN-B and IPMN-P all of which were treated *** hereby report the case of a 76-year-old woman who was incidentally diagnosed with both an asymptomatic 3 cm bulky uid lesion obstructing the bile duct lumen,diagnosed as a malignant IPMN-B,and synchronous multiple pancreatic cystic lesions(10-13 mm) communicating with an irreg-ular Wirsung,diagnosed as branch duct *** surgery was ruled-out because of the patient's age and preferences,she underwent a conservative manage-ment regimen comprising both chemotherapy and *** was effective in decreasing the mass size and in resolving subsequent *** is also the f irst reported case of IPMN-B successfully treated with *** should consider medical treatment as an option in this clinical scenario,in pa-tients who may be unf it for surgery.

关键词： Intraductal papillary neoplasm Bile duct Simultaneous Pancreatic intraductal papillary mucinous neoplasm

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