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Ann Surg Oncol 2019 Feb 20. Epub 2019 Feb 20.

Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Zhonghua Bing Li Xue Za Zhi 2019 Feb;48(2):92-97

Department of Pathology, Peking University People's Hospital, Beijing 100044, China.

To investigate the expression of immunomarkers CK7, CK20, CK17, CDX2, MUC1 and MUC2 in primary adenocarcinoma of the ampulla of Vater, to explore the role of these markers in the histopathologic subclassification of ampullary carcinoma; and to provide biologic basis for precision treatment of patients with different types of ampullary carcinoma. Forty-two cases of primary ampullary carcinoma were collected at Peking University People's Hospital, from 2012 to 2018 year. There were 22 males and 20 females. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2024-2026

Dept. of Gastrointestinal Tract Surgery, Fukushima Medical University.

We report 2 cases of superficial non-ampullary duodenal tumor resected using laparoscopic endoscopic cooperative surgery( LECS). A man in his5 0's underwent screening esophagogastroduodenoscopy. Endoscopy revealed a 0-Ⅱc lesion at the anal side of the papilla of Vater that measured 5 mm. Read More

Ann Surg Oncol 2019 Jan 18. Epub 2019 Jan 18.

Department of Hepatobiliary and Pancreatic Surgery, First Hospital of Jiaxing, First Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, People's Republic of China.

Objective: The aim of this study was to establish and validate an individualized nomogram for predicting disease-specific survival (DSS) in patients with non-metastatic ampullary carcinoma after surgery.

Methods: The nomogram was prepared using retrospective data from the Surveillance, Epidemiology, and End Results database, and included 2022 patients (training dataset: 1276; validation dataset: 746 patients) with non-metastatic ampullary carcinoma who were surgically treated between 2004 and 2014. Cox multivariate regression was performed to identify independent risk factors. Read More

Scand J Gastroenterol 2019 Jan 13:1-7. Epub 2019 Jan 13.

a Division of Endoscopy , Shizuoka Cancer Center , Shizuoka , Japan.

Background And Aim: Differentiation of low-grade adenoma (Vienna category 3, C3) and high-grade adenoma/carcinoma (C4/5) among superficial non-ampullary duodenal epithelial tumors (SNADETs) using magnified endoscopy with narrow-band imaging (MNBI) is not established. The aim of this study is to clarify the diagnostic ability of MNBI to differentiate between C3 and C4/5 among SNADETs.

Methods: A total of 585 MNBI images taken from 156 SNADETs were evaluated in a test and validation phase. Read More

J Pancreat Cancer 2018 1;4(1):41-44. Epub 2018 Aug 1.

Department of Surgery, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.

Metastases of renal cell carcinoma (RCC) to the pancreas are rare, whereas recurrence of pancreatic ductal adenocarcinoma (PDA) or a primary periampullary cancer is far more common. The time elapsed between a primary tumor and a new mass can aid in differentiation between the two. A 70-year-old man with a history of RCC status after left nephrectomy and ampullary adenocarcinoma status after pancreaticoduodenectomy presents with an incidentally found mass in his remnant pancreas. Read More

Cancer 2019 Jan 8. Epub 2019 Jan 8.

Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Background: Ampullary carcinoma (AC) is a rare gastrointestinal cancer. Pathogenic germline alterations (PGAs) in BRCA2 and potentially targetable somatic alterations (SAs) in ERBB2 and ELF3 have been previously described in AC. Memorial Sloan Kettering Cancer Center has implemented an opt-in strategy for germline testing (GT) and somatic testing (ST) for patients with AC to further evaluate the spectrum of PGAs and SAs. Read More

Gastroenterology 2019 Jan 4. Epub 2019 Jan 4.

Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan. Electronic address:

Int J Med Robot 2018 Dec 22:e1979. Epub 2018 Dec 22.

Gastroenterology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.

Background: The adoption of minimally invasive surgery for transduodenal ampullectomy has been slow because of special characteristics and complexity of this procedure.

Methods: Six patients underwent robotic transduodenal ampullectomy. We employed novel methods to facilitate exposure of the ampulla. Read More

J Surg Oncol 2019 03 18;119(3):303-317. Epub 2018 Dec 18.

Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, Texas.

Background And Objectives: Periampullary adenocarcinoma (PAC) is stratified anatomically: ampullary adenocarcinoma (AA), distal cholangiocarcinoma (DCC), duodenal adenocarcinoma (DA), and pancreatic ductal adenocarcinoma (PDAC). We aimed to determine differences in incidence, prognosis, and treatment in stage-matched PAC patients in a longitudinal study.

Methods: PAC patients were identified in The National Cancer Database from 2004 to 2012. Read More

J Surg Oncol 2019 Mar 12;119(3):295-302. Epub 2018 Dec 12.

Pathology and Laboratory Medicine Department, University of California, Los Angeles, California.

Objectives: To investigate the function of immunomarkers CK7, CK20, CK17, CDX2, MUC1, and MUC2 in the identification of primary ampullary carcinoma mixed subtype.

Methods: Forty-two cases of primary ampullary carcinoma were performed by immunohistochemical studies. The correlation between the mixed subtype and the other two subtypes and patient survival data was analyzed using the SPSS 16. Read More

J Gastrointest Oncol 2018 Oct;9(5):871-874

Multiple Organ Transplant Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia.

Periampullary carcinoma includes neoplasms arising from head of pancreas, distal common bile duct, duodenum and ampulla of Vater. We report a case of a 41-year-old male, medically free who presented to our hospital as a case of obstructive jaundice, weight loss, headache and blurred vision. Clinical evaluation revealed memory loss and ataxia. Read More

World J Gastrointest Oncol 2018 Nov;10(11):370-380

Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona 37134, Italy.

Ampulla of Vater is a peculiar anatomical structure, characterized by the crossroad of three distinct epithelia: Intestinal, ductal pancreatic and biliary. Adenocarcinomas arising in this area represent an opportunity to understand the comparative biology of all periampullary malignancies. These neoplasms can exhibit intestinal, pancreaticobiliary or mixed features, whereas the subclassification based on morphology and immunohistochemical features failed in demonstrating a robust prognostic reliability. Read More

Surg Endosc 2019 Feb 12;33(2):612-619. Epub 2018 Nov 12.

Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, 28#, Fuxing Road, Beijing, 100853, China.

Aim: To establish the clinical value of endoscopic papillectomy for duodenal papillary tumor based on endoscopic and clinical characteristics.

Patients And Methods: This single-center, retrospective study included 110 patients with duodenal papillary tumor who underwent endoscopic papillectomy between January 2006 and April 2017 at the gastrointestinal endoscopic center of the Chinese PLA General Hospital. Clinical data, postoperative pathology, procedure-related complications, and therapeutic outcomes were analyzed. Read More

Cardiovasc Intervent Radiol 2019 Feb 8;42(2):276-282. Epub 2018 Nov 8.

Department of Interventional Radiology, The First Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China.

Objective: To evaluate predictive factors of recurrent biliary obstruction (RBO) following percutaneous uncovered metal stent placement for unresectable distal malignant biliary obstruction (MBO) by using a competing risk model.

Materials And Methods: Between March 2012 and March 2016, 119 patients underwent percutaneous uncovered metal stent placement with distal MBO at our institution. Univariate and multivariate analyses were conducted to identify the prognostic factors for RBO using a competing risk model. Read More

PLoS One 2018 16;13(10):e0205864. Epub 2018 Oct 16.

Department of Surgery, Kitasato University Hospital, Kitasato, Minami-ku, Sagamihara, Kanagawa, Japan.

Background: Promoter DNA methylation of Cysteine dioxygenase type1 (CDO1) gene has been clarified as a molecular diagnostic and prognostic indicator in various human cancers. The aim of this study is to investigate the clinical relevance of CDO1 methylation in primary biliary tract cancer (BTC).

Methods: CDO1 DNA methylation was assessed by quantitative methylation-specific PCR in 108 BTC tumor tissues and 101 corresponding normal tissues. Read More

J Gastroenterol Hepatol 2018 Oct 2. Epub 2018 Oct 2.

Department of Hepatobiliary Surgery and Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Background And Aim: Magnetic anastomosis has been attempted in biliary and intestinal reconstruction. The objective of the current study was to introduce an initial clinical use of magnetic compression anastomosis for pancreaticojejunostomy and biliojejunostomy in Whipple's procedure.

Methods: Patients with peri-ampullary carcinoma and dilated bile and pancreatic ducts were prospectively enrolled from 2016 to 2017. Read More

Hum Pathol 2018 Sep 24. Epub 2018 Sep 24.

Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address:

Identifying the accurate origin of periampullary cancers is important, because different origins may trigger different clinicopathologic behaviors. The presence of intraepithelial precursor lesions, including high-grade pancreatic intraepithelial neoplasias (PanINs) and/or high-grade biliary intraepithelial neoplasias (BilINs), may be suggestive of the origin of the periampullary carcinoma in challenging cases. To prove the usefulness of high-grade intraepithelial precursor lesions to identify the origin of ambiguous periampullary cancers, the status and grades of PanINs and BilINs were evaluated in 256 periampullary carcinomas with a well-defined cancer origin as a test set, including 114 pancreatic cancers, 82 distal bile duct cancers, 54 ampullary cancers, and 6 duodenal cancers, and 112 periampullary carcinomas with clinically equivocal epicenter either by radiologic imaging used as a validation set. Read More

Cureus 2018 Jul 23;10(7):e3035. Epub 2018 Jul 23.

UAB Medicine, Huntsville Regional Medical Campus, Huntsville Hospital, Huntsville, USA.

Periampullary malignancies arise in the vicinity of the ampulla of Vater, a common passage for biliary and pancreatic secretions. Determining the anatomical origin of these tumors represents a diagnostic challenge. This is especially true for large tumors due to the transitional nature of this region, proximity to different structures, anatomical variations, and overlapping features among constituting structures. Read More

Oncol Lett 2018 Oct 8;16(4):4879-4888. Epub 2018 Aug 8.

Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Peking Union Medical College, Beijing 100730, P.R. China.

The objective of the present study was to evaluate whether preoperative platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) could predict the prognosis for curative resected ampullary carcinoma. A total of 94 patients were retrospectively included over a 6-year period in which consecutive cases underwent pancreaticoduodenectomy for ampullary malignancy. Preoperative blood results were available in the 94 cases of resected ampullary carcinoma. Read More

Mol Clin Oncol 2018 Oct 14;9(4):362-368. Epub 2018 Aug 14.

Department of Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan.

Systemic inflammatory-, immunological- and nutritional-based indices, such as the neutrophil-to-lymphocyte ratio (NLR), the prognostic nutritional index (PNI) and the Glasgow prognostic score (GPS), are drawing considerable research attention to predict the long-term prognosis of many types of cancer. Recently, these parameters have also been reported to be useful in predicting postoperative morbidity in several fields, including colorectal and otolaryngological cancer. However, while distal cholangiocarcinoma exhibits a high morbidity rate, its risk factors of morbidity have not yet been established. Read More

Anticancer Res 2018 Sep;38(9):5379-5386

Department of Surgery, Charité University of Medicine Berlin, Berlin, Germany.

Background: Periampullary carcinomas generally confer a poor outcome. Choosing the most effective treatment regimen for each sub-entity proves challenging and is usually based on experience from pancreatic adenocarcinoma (PDAC).

Patients And Methods: The long-term follow-up is presented of 472 patients with periampullary tumors [PDAC, distal cholangiocarcinoma (dCC) and ampullary carcinomas (AC)] who underwent radical resection considering clinical characteristics, paraclinical findings and histopathological features in order to define factors of prognostic relevance. Read More

Am J Case Rep 2018 Sep 5;19:1063-1067. Epub 2018 Sep 5.

Department of Surgery, Mount Lebanon Hospital, Beirut, Lebanon.

BACKGROUND Duodenal and ampullary carcinoids are very rare tumors accounting respectively for 2% and 0.03% of all carcinoid tumors. Clinical findings vary according to the location of the tumor within the periampullary region; with epigastric pain being the most common presenting symptom in duodenal carcinoids and jaundice the most common clinical finding in ampullary carcinoids. Read More

Dig Endosc 2018 Aug 30. Epub 2018 Aug 30.

Third Department of Surgery, Tokyo Medical University, Tokyo, Japan.

Background And Aim: Endoscopic papillectomy (EP) has been attempted not only for benign lesions but also for early ampullary carcinoma (AC). However, there is still no sufficient evidence or consensus regarding the effectiveness of EP for early AC. Herein, we evaluated the expanding indication of EP for early AC. Read More

Hepatobiliary Pancreat Dis Int 2018 Oct 7;17(5):443-449. Epub 2018 Aug 7.

Gastroenterology Surgical Center, Mansoura University, Mansoura 35516, Egypt.

Background: Pancreaticoduodenectomy (PD) is the standard curative treatment for periampullary tumors. The aim of this study is to report the incidence and predictors of long-term survival (≥ 5 years) after PD.

Methods: This study included patients who underwent PD for pathologically proven periampullary adenocarcinomas. Read More

Rev Gastroenterol Peru 2018 Apr-Jun;38(2):187-191

Hospital Regional de Tumbes. Tumbes, Perú.

To report the first case of Whipple surgery performed at the Regional Hospital of Tumbes for the treatment of ampullary adenocarcinoma with successful results. A case report of a patient with diagnosis of ampullary adenocarcinoma, in whom was performed the first Whipple surgery at the Regional Hospital of Tumbes, in October, 2014. The patient diagnosed with an obstructive jaundice syndrome due to ampullary adenocarcinoma underwent Whipple surgery. Read More

Cancer Biol Ther 2018 1;19(10):887-897. Epub 2018 Aug 1.

a Departments of Translational Research (SAL, RS, AJOA, MS, EG, Y-PS); Surgical Oncology (JPA), Florida Hospital Cancer Institute , Orlando , FL , USA.

Circulating tumor cells (CTC) enter the blood from many carcinomas and represent a likely source of metastatic dissemination. In contrast to the peripheral circulation, KRAS mutation- positive CTC thrive in the portal venous blood of patients with pancreatic ductal adenocarcinoma (PDAC). To analyze the essential interactions that contribute to carcinoma CTC growth and immune resistance, portal venous blood was collected during pancreatico-duodenectomy in 41 patients with peri-ampullary pathologies (PDAC = 11; ampullary adenocarcinoma (AA) = 15; distal cholangiocarcinoma (CC) = 6; IPMN = 7; non-malignant pancreatitis = 2). Read More

Biomark Res 2018 27;6:25. Epub 2018 Jul 27.

6Department of Pathology, Massachusetts General Hospital, Boston, MA USA.

Background: Diagnosing pancreatic ductal adenocarcinoma (PDAC) in the setting of metastasis with an unknown primary remains very challenging due to the lack of specific biomarkers. HNF-1B has been characterized as an important transcription factor for pancreatic development and was reported as a biomarker for clear cell subtype of PDAC.

Methods: To investigate the diagnostic role of HNF-1B for PDAC, we used tissue microarray (TMA) and immunohistochemistry (IHC) to characterize HNF-1B expression in a large cohort of carcinomas, including 127 primary PDACs, 47 biliary adenocarcinomas, 17 metastatic PDACs, and 231 non-pancreaticobiliary carcinomas. Read More

J Int Med Res 2018 Nov 20;46(11):4634-4639. Epub 2018 Jul 20.

3 Pathology Department, University of Nis Medical School, Bul.dr Z.Djindjica, Nis, Serbia.

Objective: Periampullary carcinomas are a group of neoplasms with variable histopathology that originate from the anatomical junction of different epithelial types including the bile duct, pancreatic duct, and duodenal mucosa. This study was performed to determine whether the histopathologic type of these tumors should be considered an independent prognostic factor.

Methods: We analyzed the specimen histopathology of 37 patients who underwent radical cephalic pancreatoduodenectomy for carcinoma of the ampulla of Vater during a 5-year period. Read More

Virchows Arch 2018 Sep 11;473(3):265-273. Epub 2018 Jul 11.

Pathology Department, & Centre for Colorectal Disease, UCD Medical School, St. Vincent's University Hospital, Dublin, Ireland.

The small intestine represents 75% of the length and 90% of the absorptive surface area of the gastrointestinal tract (GIT), yet only 2% of digestive system cancers occur at this site. Adenocarcinoma accounts for half of small bowel malignancies. There have been a number of important recent advances in our understanding, classification and treatment of small bowel tumours. Read More

GE Port J Gastroenterol 2018 Jun 26;25(4):195-197. Epub 2017 Oct 26.

Gastroenterology Department, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.

Int J Surg Pathol 2019 Feb 11;27(1):89-93. Epub 2018 Jul 11.

6 Unit of Digestive Endoscopy, Università Cattolica del Sacro Cuore, Rome, Italy.

Carcinoma of the ampulla of Vater is an uncommon neoplasm and represents 0.5% of all gastrointestinal malignancies, being less common than carcinoma of the pancreas and bile ducts. The most common ampullary tumor is the adenocarcinoma with tubular growth pattern. Read More

Ann Surg Treat Res 2018 Jul 26;95(1):22-28. Epub 2018 Jun 26.

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Purpose: Transduodenal ampullectomy (TDA) has been reported in a limited number of cases and in a small number of case series. The aim of this study was to analyze perioperative and long-term oncological outcomes of patients with ampullary tumors who underwent TDA in a single large-volume center.

Methods: Through a retrospective review of data from 2004 to 2016, we identified 26 patients who underwent TDA at Asan Medical Center. Read More

BMJ Case Rep 2018 Jun 27;2018. Epub 2018 Jun 27.

Radiation-Oncology Department, Shohada-e Tajrish Hospital, Tehran, Iran.

We describe a case report of a 53-year-old man with a 5-months history of progressive jaundice and upper abdominal pain. The patient was further evaluated and finally diagnosed with a high-grade ampullary neuroendocrine tumour (based on endoscopic-guided biopsy). Thereafter, he underwent pancreatoduodenectomy and adjuvant platinum-based chemotherapy. Read More

Rom J Morphol Embryol 2018 ;59(1):311-315

Department of Gastroenterology, University of Medicine and Pharmacy of Tirgu Mures, Romania;

Primary duodenal cancer is a rare entity accounting for only 0.3% of all gastrointestinal cancers. Histopathologically, most duodenal cancers are mucin-producing adenocarcinomas, 34% being poorly differentiated. Read More

Jpn J Clin Oncol 2018 Aug;48(8):743-747

Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Oita, Japan.

Background: Non-ampullary duodenal adenocarcinoma, excluding carcinoma in the ampulla of Vater, is a rare disease. Although several prognostic factors have been reported, they remain controversial due to the rarity of non-ampullary duodenal adenocarcinoma. The aims of this study were to investigate prognostic factors in patients with non-ampullary duodenal adenocarcinoma and to assess chemotherapy in patients with recurrence. Read More

Gastroenterology Res 2018 Jun 31;11(3):231-234. Epub 2018 May 31.

Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USA.

We present a case of a 60-year-old female patient who has significant medical history of renal cell carcinoma diagnosed 2 years back and had undergone right nephrectomy and chemotherapy. She presented to the hospital with complaints of abdominal pain and jaundice of 2 weeks duration and was found to have periampullary mass lesion causing compression of distal common bile duct on imaging with computed tomography of abdomen. Endoscopic retrograde cholangiography and endoscopic ultrasound showed ampullary mass lesion causing biliary obstruction along with abdominal lymphadenopathy. Read More

Jpn J Clin Oncol 2018 Aug;48(8):703-711

Department of Medical Oncology, Faculty of Medicine, Kyorin University, Tokyo, Japan.

Biliary tract cancer, carcinoma of the extrahepatic bile ducts, carcinoma of the gall bladder, ampullary carcinoma and intrahepatic cholangiocarcinoma are often identified at an advanced stage and have poor prognoses. Although effective chemotherapy regimens are needed, their development remains unsatisfactory. From the results of a phase III clinical trial (ABC-02 trial), gemcitabine plus cisplatin is the standard first-line chemotherapeutic regimen for advanced biliary tract cancer. Read More

J Coll Physicians Surg Pak 2018 Jun;28(6):485-487

Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore.

Option for borderline resectable pancreatic cancer is pancreaticoduodenectomy (PD) with vascular resection and reconstruction. We would like to share our experience of vascular reconstruction. First patient was a 51-year male with pancreatic head carcinoma, involving posterior wall of portal vein (PV) and replacing right hepatic artery (RHA). Read More

Mutat Res 2018 Apr - Jun;776:10-22. Epub 2018 Mar 17.

Department of Zoology, Avinashilingam Institute for Home Science and Higher Education for Women - Avinashilingam University for Women, Coimbatore 641 043, Tamil Nadu, India.

Ampulla of vater carcinoma (AVC) is a rare gastrointestinal tumour that is associated with a high mortality rate and it's often diagnosed at later stages due to lack of clinical symptoms. Early diagnosis of this condition is essential to effectively treat patients for better prognosis. A significant amount of advancement has been made in understanding the molecular nature of cancer in the past decade. Read More

Case Rep Gastroenterol 2018 Jan-Apr;12(1):194-201. Epub 2018 Apr 27.

Department of Surgery, Universitair Medisch Centrum Groningen, Groningen, The Netherlands.

Signet ring cell carcinoma (SRCC) of the ampulla of Vater is an extremely rare tumor. Our case describes a 45-year-old female presenting with jaundice and pruritus. Computed tomography, endoscopy, and endoscopic retrograde cholangiopancreatography showed a tumor of the ampulla of Vater without distant metastasis. Read More

Indian J Cancer 2017 Jul-Sep;54(3):519-525

Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.

Objectives: We aimed to study the compliance and treatment outcome of patients who received adjuvant treatment following curative resection for periampullary cancers periampullary cancers.

Materials And Methods: Institute medical records of PAC treated during 2007-2014 were retrieved. Demographics, treatment, and outcome in patients who were intended to receive adjuvant chemoradiation after curative resection were analyzed. Read More

Jpn J Radiol 2018 Aug 21;36(8):477-488. Epub 2018 May 21.

Department of Radiology, Thammasat University Hospital, 95 Moo 8, Phahon Yothin Road, Khlong Luang, Pathum Thani, 12110, Thailand.

Purpose: To determine useful CT parameters to differentiate ampullary carcinomas from benign ampullary obstruction.

Materials And Methods: This study included 93 patients who underwent abdominal CT, 31 patients with ampullary carcinomas, and 62 patients with benign ampullary obstruction. Two radiologists independently evaluated CT parameters then reached consensus decisions. Read More

Turk J Gastroenterol 2018 05;29(3):325-334

Division of Gastroenterology and Hepatology, Ankara High Speciality Training and Research Hospital, Ankara, Turkey.

Background/aims: Endoscopic papillectomy (EP) has emerged as an alternative to surgery in the management of ampullary lesions. The aim of this study is to evaluate feasibility, efficacy, safety, outcome, and impact of EP in the management of benign ampullary lesions.

Materials And Methods: This is a multicenter, retrospective study of 44 patients who had EP of benign ampullary lesions. Read More

Australas J Dermatol 2018 Nov 9;59(4):e269-e272. Epub 2018 May 9.

Department of Dermatology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.

Pancreatic panniculitis is a rare type that only occurs in 2-3% of all patients with pancreatic diseases. It is usually described in association with benign pancreatic disease and less commonly in association with pancreatic carcinoma. We describe a case of pancreatic panniculitis as the first manifestation of underlying ampullary adenocarcinoma and a new case of pancreatitis, panniculitis and polyarthritis (PPP-Syndrome). Read More

Am J Surg Pathol 2018 Aug;42(8):1095-1100

Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR.

Endoscopic mucosal biopsies of the ampulla of Vater (AmpBx) are obtained to histologically assess for dysplasia or carcinoma. However, biopsy material is often scant and a host of factors can induce histologic changes that pose diagnostic challenges. We sought to investigate observer variability in interpretation of AmpBx and the impact clinical data may have on diagnostic interpretation. Read More

Pathol Res Pract 2018 Jun 1;214(6):835-839. Epub 2018 May 1.

Department of Medicine (DIMED), University of Padua, Padua, PD, Italy. Electronic address:

Poor information is available on the molecular landscape characterizing the carcinogenetic process leading to ampullary carcinoma. MiR-21 is one of the most frequently up-regulated miRNAs in pancreatic adenocarcinoma, a tumor sharing similar molecular features with ampullary adenocarcinomas (AVCs), above all with the pancreatic-biliary type. We profiled, by in situ hybridization (ISH), miR-21 expression in a series of 26 AVCs, 50 ampullary dysplastic lesions (35 low-grade [LG-IEN] and 15 high-grade [HG-IEN]) and 10 normal duodenal mucosa samples. Read More

Int J Clin Oncol 2018 Oct 28;23(5):894-899. Epub 2018 Apr 28.

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.

Background: The role of adjuvant chemotherapy has not yet been established for patients with resected biliary tract cancer. S-1 has been shown to exert activity against advanced biliary tract cancer. Therefore, we evaluated the feasibility of adjuvant chemotherapy with S-1 in patients with resected biliary tract cancer. Read More

Am J Dermatopathol 2018 Oct;40(10):758-761

Department of Dermatology, Los Angeles Medical Center (LAMC), Southern California Kaiser Permanente, Los Angeles, CA.

Cutaneous metastases from an adenocarcinoma of the Ampulla of Vater are very rare, with only a few cases previously reported. We present here an additional case in a 57-year-old woman who complained of a painful growth on her frontal scalp that she had noticed 4 months earlier. Her medical history included an ampullary adenocarcinoma, which was diagnosed 4 years ago, excised through a Whipple procedure, and treated using chemotherapy and radiotherapy. Read More

Gastrointest Endosc 2018 Sep 13;88(3):511-518. Epub 2018 Apr 13.

Université Paris 5, INSERM U1016, Institut Cochin, Paris, France; Service de Gastroentérologie, Hôpital Cochin, Assistance publique hôpitaux de Paris, Paris, France.

Background And Aims: Endobiliary dysplasia may persist after endoscopic papillectomy. Intraductal radiofrequency ablation (ID-RFA) is a potential alternative to complementary surgery. The aim of this study was to evaluate the efficacy and safety of ID-RFA for the treatment of adenomatous intraductal residue after endoscopic papillectomy. Read More