Abstract
A 50-year-old male was hospitalized for further investigations after clinical features suggestive of hepatic dysfunction were detected. Ultrasonography, magnetic resonance cholangiopancreatography, and multidetector computed tomography revealed biliary dilation and enhancement of a tumor in the distal common bile duct. Duodenoscopy revealed pale mucosa with granules and nodules over the entire circumference of the descending 2nd portion. The ampulla of Vater was located in the center of the lesions, and adenocarcinoma was detected on biopsy. Percutaneous transhepatic cholangioscopy was performed following percutaneous transhepatic cholangiodrainage, and polyp-like elevated lesions were observed extruding from the papillary portion into the biliary lumen. Papillary carcinoma was diagnosed and pancreatoduodenectomy was performed. Histopathological findings revealed a well-differentiated adenocarcinoma with partial invasion of the tissue surrounding the sphincter of Oddi in the ampulla of Vater alone and superficial spread across the lower bile duct, pancreatic duct, and duodenum. We report a case of carcinoma of the ampulla of Vater without deep invasion that showed superficial spread over the entire circumference of the descending portion of the duodenum and distal bile duct.
