Synchronous Presentation of Ampullary Adenocarcinoma and Common Bile Duct Cancer: Report of a Case and Review of Literature

  • Max V Wohlauer Section of GI, Tumor and Endocrine Surgery, Department of Surgery, University of Colorado at Denver. Aurora, CO, USA
  • Martine C McManus Division of Gastrointestinal Pathology, Department of Pathology, University of Colorado at Denver. Aurora, CO, USA
  • Brian Brauer Division of Gastroenterology and Hepatology, Department of Medicine, University of Colorado at Denver. Aurora, CO, USA
  • Jeremy Hedges Section of GI, Tumor and Endocrine Surgery, Department of Surgery, University of Colorado at Denver. Aurora, CO, USA
  • Csaba Gajdos Section of GI, Tumor and Endocrine Surgery, Department of Surgery, University of Colorado at Denver. Aurora, CO, USA
DOI: https://doi.org/10.6092/1590-8577/836
Keywords: Adenocarcinoma, Adenoma, Ampulla of Vater, Cholangiopancreatography, Endoscopic Retrograde, Common Bile Duct Neoplasms, Neoplasms, Multiple Primary, Pancreaticoduodenectomy, Adult, Lymphatic Metastasis, Aged

Abstract

Context Ampullary adenocarcinomas and bile duct cancers represent a very small minority of all gastrointestinal malignancies. Synchronous presentation of both malignancies is extremely rare. Case report We report a case of a 76-year-old male who presented with painless jaundice. His work-up showed an ampullary mass and a separate common bile duct stricture. Attempted endoscopic resection established the diagnosis of ampullary adenocarcinoma. Pathologic examination of the Whipple specimen identified a separate focus of bile duct cancer. Conclusion Synchronous presentation of an ampullary mass and separate distal bile duct stricture, especially in elderly patients, should raise concern for both lesions representing malignancies. In the absence of conclusive evidence for survival advantage in resected early stage ampullary and biliary cancers, close observation should be considered a valid alternative to adjuvant chemotherapy and radiation.

Image: EUS showing a hypoechoic oval mass in the ampulla.

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EUS showing a hypoechoic oval mass in the ampulla
Published
2012-09-10
How to Cite
WohlauerM., McManusM., BrauerB., HedgesJ., & GajdosC. (2012). Synchronous Presentation of Ampullary Adenocarcinoma and Common Bile Duct Cancer: Report of a Case and Review of Literature. JOP. Journal of the Pancreas, 13(5), 536-539. https://doi.org/10.6092/1590-8577/836
Issue
Vol 13 No 5 (2012): September - p. 470-547
Section
CASE REPORTS

Copyright (c) 2014 Max V Wohlauer, Martine C McManus, Brian Brauer, Jeremy Hedges, Csaba Gajdos

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