2023 Volume 37 Issue 2 Pages 229-238
A 60s man with jaundice was referred to our hospital. CT scan demonstrated swelling lymph nodes around the head of pancreas, and dilatation of the common bile duct. Cholangiography showed the stenosis of the lower bile duct. Endoscopy showed a tumor of the ampulla of Vater and biopsy results showed neuroendocrine carcinoma. CT just before operation revealed portal vein tumor thrombus (PVTT). A subtotal stomach preserving pancreaticoduodenectomy combined with portal vein resection was performed. Postoperative histological examination revealed neuroendocrine carcinoma of the ampulla of Vater (pT3bN1M0). Post-operative chemotherapy was conducted based on chemotherapy for small-cell carcinoma of the lung. The patient died of multiple liver metastases 19 months after operation. Only 29 cases of neuroendocrine carcinoma of the ampulla of Vater have been reported in Japan in the last 22 years. This was the second report of carcinoma of the ampulla of Vater with PVTT.
