A Case of Duodenal Recurrence due to Implantation following Transduodenal Ampullectomy of the Cancer of the Ampulla

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  • 乳頭部切除後十二指腸切開部に着床性再発が疑われた乳頭部癌の1例
  • 症例 乳頭部切除後十二指腸切開部に着床性再発が疑われた乳頭部癌の1例
  • ショウレイ ニュウトウブ セツジョ ゴ ジュウニシチョウ セッカイブ ニ チャクショウセイ サイハツ ガ ウタガワレタ ニュウトウブガン ノ 1レイ

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Abstract

A 65-year-old woman underwent transduodenal ampullectomy of a papillary adenoma of the Ampulla of Vater. The pathological diagnosis was cancer of the Ampulla of Vater (JSBS classification : pT2, pN0, M0, p-stage II).<BR>The patient underwent follow-up examinations with periodic gastroscopy. After 30 months, a lesion similar to a submucosal tumor was detected on the other side of the Ampulla of Vater. The lesion location corresponded to the transduodenal ampullectomy incision site made in the duodenum. The lesion was diagnosed as an adenocarcinoma based on the biopsy findings. Pylorus-preserving pancreatoduodenectomy was performed. The pathological diagnosis was duodenal carcinoma (UICC classification : mucinous adenocarcinoma, type 2. 25 × 25 mm, T3 (SS), N0, M0, stage IIA). This second adenocarcinoma was believed to be a recurrence of the original cancer of the Ampulla of Vater, having been implanted into the duodenum at the time of transduodenal ampullectomy. Although it rarely occurs, this condition should be carefully considered when evaluating and following patients with a similar history.

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