Abstract
To clarify the relation between the macroscopic appearances and extent of the carcinoma of the papilla of Vater,26 cases were examined; 25 cases underwent pancreaticoduodenectomy and a case done papillectomy. Macroscopic classification of carcinomas were based on the General Rules for Surgical and Pathological Studies on Cancer of the Biliary Tract. In addition, the exposed tumor type in the General Rules is further subclassified into three categories, non-erosive, erosive and orifice-expansive subtypes. The invasion of carcinoma beyond Oddi's muscle layer was found in 20 of 26 tumors (76.9%); all cases in non-exposed tumor type, erosive subtype and ulcerforming type were invasive, but on invasion of carcinoma in non-erosive subtype and polyp type was found. Two of four in orifice-expansive subtype were invaded beyond Oddi's muscle layer. Lymphatic metastates were found is 7 of 26 cased (26.9%) in the only three groups; non-exposed type (1/3=33.3%), erosive subtype (4/10=40%) and ulcer-forming type (2/5=40%). Intraepithelial extension in the pancreatic duct and/or biliary duct was detected in all groups (12/26=46.2%). Macroscopic characterisitics of tumors seemed to make it possible to evaluate the depth of carcinoma of the papilla of Vater.
