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A rare synchrony of adenocarcinoma of the ampulla with an ileal gastrointestinal stromal tumor: A case report

World Journal of Gastrointestinal Oncology 2022年第11期14卷 2253-2265页

作者： Venkata Vinod Kumar Matli Gazi B Zibari Gregory Wellman Poornima Ramadas Sudha Pandit James Morris Department of Internal Medicine Christus Highland Medical CenterShreveportLA 71106United States Division of Hepatobiliary Surgery Willis-Knighton Health SystemShreveportLA 711103United States Department of Gastrointestinal and Liver Pathology Christus Highland Medical CenterShreveportLA 71105United States Division of Hematology and Oncology Louisiana State University Health Sciences CenterShreveportLA 71103United States Division of Gastroenterology and Hepatology Louisiana State University Health Sciences CenterShreveportLA 71103United States

BACKGROUND This is a unique case of a patient who was found to have two extremely rare primary malignancies synchronously,i.e.,an ampullary adenocarcinoma arising from a high-grade dysplastic tubulovillous adenoma of the ampulla of Vater(TVAoA)with a high-grade ileal gastrointestinal stromal tumor(GIST).Based on a literature review and to the best of our knowledge,this is the first report of this *** ampullary tumors are extremely rare,with an incidence of four cases per million population,which is approximately 0.0004%.Distal duodenal polyps are uncommon and have a preponderance of occurring around the ampulla of *** adenoma of the ampulla(AoA)may occur sporadically or with a familial inheritance pattern,as in hereditary genetic polyposis syndrome such as familial adenomatous polyposis syndrome(FAPS).We report a case of a 77-year-old male who was admitted for painless obstructive jaundice with a 40-pound weight loss over a two-month period and who was subsequently diagnosed with two extremely rare primary malignancies,i.e.,an adenocarcinoma of the ampulla arising from a high-grade TVAoA and a high-grade ileal GIST found *** SUMMARY A 77-year-old male was admitted for generalized weakness with an associated weight loss of 40 pounds in the previous two months and was noted to have painless obstructive *** physical examination was benign except for bilateral scleral and palmar *** results were significant for an obstructive pattern on liver *** lipase and carbohydrate antigen-19-9 levels were *** tomography(CT)of the abdomen and pelvis and magnetic resonance cholangiopancreatography were consistent with a polypoid mass at the level of the common bile duct(CBD)and the ampulla of Vater with CBD *** same lesions were visualized with endoscopic retrograde *** of endoscopic forceps biopsy showed *** of the surgical specimen of the

关键词： Tubulovillous adenoma of the ampulla of Vater ampullary adenocarcinoma Gastrointestinal stromal tumor ampullary polyp Small bowel mesenchymal tumor Case report

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Rare presentation of Brunner's gland adenoma:another differentiation in patients with recurrent "idiopathic" pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2012年第1期11卷 107-110页

作者： Soumil Vyas James RA Skipworth Dimitrios Lytras Claire Smyth Anthony Mee Adrian Hatfield Charles Imber George Webster Department of Hepatobiliary & Pancreatic Surgery University College London Hospital NHS Trust Department of Gastroenterology University College London Hospital NHS Trust Department of Gastroenterology Royal Berkshire Hospital NHS Trust

BACKGROUND:Brunner's gland adenoma (BGA) is an unusual benign neoplasm arising from Brunner's glands in the *** symptomatic it presents either with duodenal obstruction or ***,pancreatitis secondary to ampullary obstruction from a BGA is very ***:A 23-year-old female presented with recurrent episodes of 'idiopathic' *** was extensively investigated and was found to have a large polypoid BGA,intermittently obstructing the *** created a ball-valve effect causing secondary intermittent obstruction of the pancreatic duct resulting in *** condition was cured surgically,through transduodenal excision of the *** reviewed the surgical literature pertaining to these unusual and similar causes of obstructive pancreatitis,not related to ***:BGA of the duodenum is a rare cause of *** investigations should be carried out in all cases of unexplained pancreatitis before classifying the condition as 'idiopathic'.Discovery of a lesion of this nature gives an opportunity to provide a permanent surgical ***:BGA adds an unusual etiology for *** patients with pancreatitis should undergo extensive investigations before being termed 'idiopathic'.Surgical excision of the BGA provides a definitive curative treatment for the adenoma and pancreatitis.

关键词： ampullary polyp Brunner's gland adenoma pancreatitis excision

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