Signet-Ring Cell Carcinoma Co-Existing with Adenocarcinoma of the Ampulla of Vater. A Case Report

摘要

Context We report a case ofsignet-ring cell carcinoma admixed with adenocarcinoma of the ampulla of Vater.Signet-ring cell carcinoma of the ampulla of Vater is rarely encountered inclinical practice. Case report A 78-year-old man was admitted to ourhospital with jaundice. Computed tomography demonstrated dilatation of thebiliary tract and an enhanced mass lesion measuring 1.5 cm in the pancreatic head. Endoscopic examination showed a reddish swollen papilla of Vater, andthe pathological findings on a biopsy from the papilla suggested signet-ringcell carcinoma. A pancreaticoduodenectomy was performed with a diagnosis ofcarcinoma of the ampulla of Vater. Postoperative pathological examinationshowed that the tumor was composed of signet-ring cell carcinoma and tubularadenocarcinoma. The signet-ring cell carcinoma had infiltrated to the duodenalwall and pancreatic parenchyma. Both the signet-ring cell carcinoma and theadenocarcinoma were positive on immunohistochemical staining with 45M1. ConclusionSeveral cases of signet-ring cell carcinoma of the ampulla of Vater havepreviously been reported. In our case, the histological origin of bothsignet-ring cell and adenocarcinoma was hypothesized to have beenpancreaticobiliary epithelial cells.