Neuroendocrine Tumours of The Ampulla Of Vater
Journal Title: IOSR Journal of Nursing and health Science - Year 2018, Vol 7, Issue 6
Abstract
Background Neuroendocrine tumors rarely occur in ampulla of Vater and their incidence in current increase, in particular malignant forms. The final diagnosis is done on histology, and sometimes it can be difficult to diagnose them preoperatively, as they present a clinical picture similar to the adenocarcinomas of this region. Case presentation Case 1 A 43-year-old woman with epigastric pain, serum alkaline phosphatase and γ-glutamine transferase high, endoscopic retrograde cholangiopancreatography (ERCP) showed choledochal metastasis on suspicious ampullary stenosis. Surgical exploration has demonstrated the presence of a mass of 4 cm at the expense of the ampulla of Vater. An ampullectomy was carried out, histological and immunological aspect was in favor of a well differentiated neuroendocrine carcinoma with expression of synaptophysin and chromogranin with a Ki 67 at 2%. The patient remained under good control with complete cure and without disease for 51 months. Case 2 A 28-year-old female consultant for cholestatic jaundice associated with general asthenia, abdominal computed tomography-scanner (CT scan) has objectified a tissue lesional process of the vater bulb protruding into the duodenal lumen, a pancreaticoduodenectomy was performed, pathologic examination and immunohistochemistry of the surgical specimen was in favor of a well-differentiated neuroendocrine tumor with expression of synaptophysin, chromogranin A and CKAE1/AE3 with a Ki 67 at 2%. The patient remained under good control with complete recovery and no signs of illness 19 months after the surgical procedure. Conclusions : Ampullary neuroendocrine tumors (ANETs) are distinct entities that present clinically with jaundice. They positively stain chromogranin A and synapthophysin immunohistochemistry. The Pancreaticoduodenal resection appears to be the procedure of choice for most patients with ANET because this procedure removes all the potential tumor-bearing tissue.
Authors and Affiliations
Hejjane Loubna, Benbrahim Zineb, Ahalli Ibtihal, Lhlou Mimi Anass, Dkhissi Yassine, Efared Boubacar, Oualla karima, Aarifi Samia, Mellas Nawef
Keywords
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- EP ID EP437162
- DOI 10.9790/1959-0706055055.
- Views 123
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