ampulla of Vater adenocarcinoma

Etiology

• risk factors
  • familial adenomatous polyposis
  • Lynch syndrome (HNPCC)

Pathology

• tumors may arise from bile duct, pancreatic duct or duodenum

Clinical manifestations

• painless jaundice
• gastric outlet obstruction (duodenal obstruction)

Laboratory

• no specific markers
• serum CA 19-9 may be elevated
• serum carcinoembryonic antigen may be elevated

Diagnostic procedures

• ERCP & endoscopic ultrasound
  • tissue sampling
  • decompression of obstruction via placing a stent
• upper gastrointestinal endoscopy & colonoscopy for surveillance of hereditary polyposis syndrome (familial adenomatous polyposis, Lynch syndrome)

Radiology

• computed tomography
• magnetic resonance imaging

Management

• surgical excision (pancreaticoduodenectomy) if no evidence of advanced disease

More general terms

• small intestinal cancer
• adenocarcinoma

Additional terms

• ampulla of Vater (hepatopancreatic, bilaropancreatic ampulla)