Open AccessCoexistent ampullary squamous cell carcinoma with adenocarcinoma of the pancreatic duct
Author(s) -
Gayatri S Pathak,
Sanjay D Deshmukh,
Prasanna A Yavalkar,
Amrut V Ashturkar
Publication year - 2011
Publication title -
the saudi journal of gastroenterology/saudi journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 32
eISSN - 1998-4049
pISSN - 1319-3767
DOI - 10.4103/1319-3767.87184
Subject(s) - ampulla of vater , medicine , major duodenal papilla , adenocarcinoma , ampulla , synaptophysin , pancreatic duct , common bile duct , chromogranin a , bile duct , gastroenterology , pancreatitis , pathology , carcinoma , immunohistochemistry , cancer
Primary squamous cell carcinoma (SCC) of ampulla has seldom been reported. However, metastatic SCC to ampulla of Vater is well known. We report a case of primary SCC of ampulla of Vater coexistent with well-differentiated adenocarcinoma of the distal pancreatic duct. A 50-year-old female presented with evidence of obstructive jaundice. Endoscopic retrograde cholangio-pancreatography revealed bulging papilla with ulcero-infiltrative growth at the ampulla of Vater. An initial endoscopic biopsy of the ampullary mass showed a well-differentiated SCC. The patient underwent Whipple's operation. Thorough sampling of the dilated portion of the pancreatic duct showed presence of well-differentiated adenocarcinoma of the distal pancreatic duct. Immunohistochemical study with synaptophysin and chromogranin was done with negative result, ruling out neuroendocrine differentiation. Also, a detailed clinical, endoscopic and radiological examination was carried out, that excluded the presence of primary SCC elsewhere.