Neuroendocrine tumors (NETs) of the ampulla of Vater are extremely rare. Here, we discuss the clinical presentation, diagnostic challenges, and treatment options of a recently experienced case of NET of the ampulla of Vater in light of the literature. A 56-year-old woman presented with recurrent upper abdominal pain. Ultrasonography (USG) of the whole abdomen showed multiple gallstones along with a dilated common bile duct (CBD). For evaluating the dilated CBD, a magnetic resonance cholangiopancreatography was performed, which revealed the double-duct sign. Subsequently, an upper gastrointestinal endoscopy showed a bulged-out ampulla of the Vater. Biopsy and histopathological examination of the growth yielded the diagnosis of adenocarcinoma. A Whipple procedure was performed. Macroscopically, a 2 cm growth was noted involving the ampulla of Vater, and microscopic findings were consistent with a well-differentiated NET, grade 1 (low grade). The diagnosis was further confirmed by immunohistochemical staining (pan-cytokeratin positive, synaptophysin positive, and focally chromogranin positive). Her postoperative course was uneventful except for delayed gastric emptying. A detailed evaluation and a high index of suspicion are required for the diagnosis of this rare tumor. Treatment is relatively easier after a proper diagnosis.

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This paper mainly aims to throw the light on telecom technologies of today and tomorrow. It briefly discusses, how technologies are now starting to be available to connect every village and also it details challenges faced by the technologies in rural areas. With these in mind, a total innovative business model is required to deliver Internet services to rural areas. In order to meet this need, a Danish technology start-up called BLUETOWN took the initiative to significantly enhance the quality of life of rural people in India in various villages of Eastern India by setting up a network of public Wi-Fi hotspots in various villages of India. The challenges from a technology point of view were many. The systems that provided the solution needed to be cost-effective, low maintenance and affordable to the rural masses [1].