Clinical and Pathologic Correlations in Patients With Periampullary Tumors

Martín, Félix; Rossi, Ricardo L.; Dorrucci, Vittorio; Silverman, Mark L.; Braasch, John W.

doi:10.1001/archsurg.1990.01410180041008

Cited by 49 publications

(16 citation statements)

References 12 publications

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“…The age of onset of periampullary noncarcinoid epithelial tumors in NF-1 patients is low: only four patients are older than 50 years old, and only two are older than 60, with an average of 47.1 (first tumor) (range 27 to 73). This type of age distribution differs from that observed for sporadic epithelial tumors of this region not associated with NF-1, which usually occur after 60 years of age (25).…”

Section: Discussioncontrasting

confidence: 80%

Ampullary Adenocarcinoma in Neurofibromatosis Type 1. Case Report and Literature Review

et al. 2001

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Periampullary tumors in patients affected by Neurofibromatosis Type 1 (NF-1) are usually carcinoids or stromal tumors and, rarely, adenocarcinomas. We report a case of an adenocarcinoma of the ampulla of Vater in a 54-year-old woman with NF-1 admitted to the hospital with jaundice and undergoing pancreato-duodenectomy. Histologically, the resected specimen showed an adenocarcinoma of the ampulla as being a part of a complex atypical epithelial proliferation extended from the papilla to the mucosa of the duodenum and distal choledochus, islet-cell adenomatosis of the pancreas and multiple gastric, duodenal, jejunal stromal tumors. The ampullary and periampullary adenocarcinomas in NF-1 patients have peculiar features, suggesting a widespread predisposition to cancer development in periampullary tissues and requiring widely demolitive surgery. Moreover, they occur at a younger age than those occurring in non-NF-1 patients, may be associated with additional periampullary epithelial tumors, are often operable and may present long survival.

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Section: Discussioncontrasting

confidence: 80%

Ampullary Adenocarcinoma in Neurofibromatosis Type 1. Case Report and Literature Review

et al. 2001

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“…So lagen in 2 Untersuchungsserien die Ffint]ahresiiberlebensraten von Karzinomen, die vonder papillennahen Duodenalschleimhaut ausgingen, mit 32% wesentlich gfinstiger als die vom terminalen Ductus choledochus ausgehenden Karzinome mit Ffinfjahresfiberlebensraten von nur 19% [5,8,22]. AuBerdem finden sich unter den polypoidwachsenden kleinen periampull/iren Karzinomen, wie sie auch in unserem Krankengut vorlagen, hfiufiger hochdifferenzierte Adenokarzinome mit gfinstigem biologischem Verhalten [5,9,14]. Diese Karzinome metastasieren sp/it und dann zunfichst nur in die vorderen bzw.…”

Section: Patienten Und Methodeunclassified

“…Diese Karzinome metastasieren sp/it und dann zunfichst nur in die vorderen bzw. hinteren pancreatikoduodenalen Lymphknoten [2,3,5,9,14]. So zeigte sich in einer Studie, dab bei periampull/iren Karzinomen im Stadium pT~ unabh/ingig vom Differenzierungsgrad und der genauen Lokalisation des Karzinoms von 15 u~,tersuchten Lymphknotengruppen nut eine befallen war, das entspricht 6,7% [2,3].…”

Section: Patienten Und Methodeunclassified

Eingeschr�nkte chirurgische Radikalit�t beim okkulten Karzinom der Papilla Vateri

Koch

Hildebrandt

Schüder

et al. 1991

Langenbecks Arch Chir

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Nine histologically proven benign adenomas of the papilla of Vater were consecutively treated by transduodenal full thickness excision and simultaneous staging of regional lymph nodes without severe postoperative complications. 4 patients had a small well differentiated (pT1 GIpN0) carcinoma, although there was neither macroscopically nor by frozen sections any suspicion of a malignant tumour. A more radical pancreatoduodenectomy was not carried out and the 4 patients are without tumour recurrence or metastases 1-8 years postoperatively.

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“…Long-term survival can be expected for 23-38% of the patients after a Whipple operation for periampullary car cinoma [22,[30][31][32][33][34], In carcinomas of the ampulla of Vater Martin et al [35] and Matory et al [36] both have reported 43% 5-year survival whereas the survival in patients with duodenal adenocarcinoma is less than 30% after resection [l]. In our series (1985-1994) of 70 pa tients the postoperative mortality and morbidity was 3 and 41%, respectively (table 2), and the 5-year survival was 10% for pancreatic cancer and 30% for cancer of the papilla of Vater (table 3).…”

Section: Pancreaticoduodenectomymentioning

confidence: 99%

Surgery of Periampullary Cancer

Ihse¹,

Axelson²,

Alsharaf³

et al. 1994

Dig Surg

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Periampullary cancers are a group of tumours with similarities in symptoms and treatment, the prognoses of which are better than that of proper ductal pancreatic carcinoma. They are still sometimes diagnosed unexpectedly at operations for other reasons, such as gallstone disease and they are best diagnosed with the triad of duodenoscopy, endoscopic retrograde cholangiopancreatography and endoscopic biopsy, but one should never rely on a negative biopsy. For evaluation of resectability chest X-ray, ultrasonography and angio-CT currently are recommended for routine use and patients with resectable tumours should be offered a Whipple operation unless their general condition and/or tumour stage contradict attempted curative surgery. Long-term survival is gratifying after resection of tumours originating in the papilla, ampulla and bile duct. This is also true for those high-risk, fragile patients undergoing local excision of the tumour with free resection margins. The obstructive jaundice in patients who are pre-operatively deemed to have incurable disease or in the very frail and old patients is preferably relieved endoscopically. In those selected for laparotomy but in whom the tumour is found to be irresectable surgical biliary bypass nowadays can be done with low hospital mortality and morbidity. We feel that prophylactic gastrojejunostomy should be done selectively. If it is not possible to control pain pharmacologically palliation can often be adequately achieved by a percutaneous coeliac bloc. Additionally, the initial results of thoracoscopic sympathectomy seem promising.

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Clinical and Pathologic Correlations in Patients With Periampullary Tumors

Cited by 49 publications

References 12 publications

Ampullary Adenocarcinoma in Neurofibromatosis Type 1. Case Report and Literature Review

Ampullary Adenocarcinoma in Neurofibromatosis Type 1. Case Report and Literature Review

Eingeschr�nkte chirurgische Radikalit�t beim okkulten Karzinom der Papilla Vateri

Surgery of Periampullary Cancer

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