ISSN 1941-5923


Welcome to the American Journal of Case Reports

Clinical case reports are an invaluable first-hand source of evidence in medicine and a tool most often used in practice to exchange information and generate a more expanded search for evidence. In addition to the “evidence of what happened”, single or multiple cases are an important basis for further and more advanced research on diagnosis,  treatment effectiveness, causes and outcomes of disease. However limited their... read more

Published: 2015-09-01

A Case of Ampullary Adenoma that Developed to Cancer 7 Years After Initial Diagnosis

Yuji Iwashita, Kei Ito, Yutaka Noda, Shinsuke Koshita, Yoshihide Kanno, Takahisa Ogawa, Kaori Masu, Yosuke Michikawa

(Department of Gastroenterology, Sendai City Medical Center, Sendai, Miyagi, Japan)

Am J Case Rep 2015; 16:586-589

ID: 894014

BACKGROUND: Although ampullary adenomas have been reported to be considered as precancerous lesions, there have been very few reports of cases in which cancer occurred after long-term follow-up. We herein report a case of ampullary adenoma that developed to cancer after long-term observation.
CASE REPORT: An 81-year-old man was referred to our hospital due to a tumor at the ampulla of Vater. Histological examination revealed a tubular adenoma. Because the patient refused treatment, follow-up by duodenoscopy, EUS, MRCP, and forceps biopsy was planned. There was no change in the tumor for 6 years. Seven years after the initial diagnosis, he developed from jaundice. Duodenoscopy showed an easy-bleeding, reddish, uneven surface area of the tumor and NBI demonstrated an irregular, non-structured surface pattern. EUS demonstrated invasion of the duodenal muscularis and infiltration into the bile duct. Histological examination revealed a well-differentiated adenocarcinoma.
CONCLUSIONS: The clinical course of this case provides evidence of the adenoma-carcinoma sequence.

Keywords: Adenocarcinoma, Adenoma, Ampulla of Vater, carcinogenesis, Narrow Band Imaging

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