Abstract
We report a case of cancer of the ampulla of Vater presenting as a polyp type. A 75-year-old woman had undergone distal gastrectomy with B-I reconstruction for advanced gastric cancer. During follow-up, bile duct dilatation was pointed out by abdominal CT, and gastroduodenoscopy showed a polyp lesion of the ampulla of Vater 32×31 mm in size. She had no clinical symptom and the laboratory data revealed mild liver dysfunction and increased serum DUPAN-2 level. Histological examination of biopsy of the ampullary lesion revealed a well differentiated tubular adenocarcinoma, and she underwent pancreatoduodenectomy on January, 2007. Pathological examination of resected specimen showed cancer invasion reaching to the duodenal muscle (JSBS classification; pT3 pN0 M0 fStage III). Ampullary cancer with polyp type is very rare, which is reported just to be 1.1% of all ampullary cancer from the reports of the cancer accumulation by Japanese Society of Biliary Surgery. Further case accumulation is required to establish the appropriate treatment plan (including endoscopic resection or operative method) for polyp type ampullary cancer.
