1992 Volume 25 Issue 9 Pages 2412-2416
We experienced a patient with a nonfunctioning islet cell tumor in the papilla of Vater. A 61-year-old woman, complaining of jaundice, was admitted to our hospital for close examination. Preoperatively, either cholangioma of the lower common bile duct or carcinoma of the papilla of Vater was suspected. At laparatory, a tumor mass was found in the papilla of Vater and a frozen section of the tumor showed evidence of malignancy, so pancreatoduodenectomy was performed. Microscopically, the tumor was composed of cells resembling the cells of the islet tissue in the adjacent pancreas. They were arranged in ribbon-like, winding cords interspersed with capillary spaces. With immunohistochemical staining, this tumor was negative for insulin, glucagon, somatostatin and pancreatic polypeptide. This patient was diagnosed clinicopathologically as having a nonfunctioning islet cell tumor in the papilla of Vater. She made a good recovery from the operation. Because nonfunctioning islet cell tumors in the papilla of Vater are uncommon and their clinical manifestations are nonspecific, the preoperative diagnosis of these tumors may be very difficult.