Abstract
A 67-year-old woman was referred to our hospital because of itching of the skin and jaundice. Blood biochemical examinations disclosed impaired hepatic function and jaundice. A contrast-enhance abdominal CT scan showed a 15 mm-sized tumor lesion at the papilla of Vater. Brushing cytology of the common bile duct at ERCP revealed proliferation of small atypical cells associated with disturbance of polarity. Non-exposing tumor type endocrine cell carcinoma was thus diagnosed. Pylorus-preserving pancreatoduodenectomy was performed. The histopathological diagnosis was adenoendocrine cell carcinoma in which adenocarcinoma and endocrine cell carcinoma components coexisted. Further the tumor had stayed within the mucosa and no lymph nodes had been involved. However, hepatic metastasis occurred six months after the operation and hepatic resection was needed.
Adenoendocrine cell carcinoma arisen in the papilla of Vater has high-grade malignant potential. When the tumor is diagnosed, it has often progressed. It carries poor prognosis even by early diagnosis and early treatments. The disease appears to have different characteristics from usual adenocarcinomas of the papilla of Vater.
