2014 Volume 28 Issue 2 Pages 228-233
We report a case of a 47-year-old woman with neuroendocrine tumor of the ampulla of Vater who underwent pyrolus-preserving pancreaticoduodenectomy with lymph node dissection. The size of the tumor was 7 mm in diameter, limited within the sphincter of Oddi. The number of the nuclear fission image of the tumor was less than 1/10 HPF, and the Ki-67 labeling index was less than 1%, so diagnosed as neuroendocrine tumor G1. One lymph node metastasis was evident in peripancreatic region. Eight years after the surgery, CT revealed multiple liver metastases recurrence of neuroendocrine tumor limited to the right lobe of the liver, so we performed right hepatectomy. The number of the liver metastases was 7 and the maximum size of them was 5 mm. The number of the nuclear fission image was less than 1/10 HPF, and the Ki-67 labeling index was 4%, so diagnosed as neuroendocrine tumor G2. Radical resection with lymph node dissection should be performed for neuroendocrine tumor of the ampulla of Vater, regardless of small size. We should observe closely after the surgery, considering presence of recurrence in the long term. Surgical resection should be considered for the recurrence regions, if total resection of the tumors is possible.
