CASE REPORTS   

Chirurgia 2013 April;26(2):189-90

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

Carcinoid tumor of the Vater’s papilla: case report

Pariani D. ¹, Pizzi M. ², Zetti G. ¹, Cortese F. ¹

¹ Operative Unit of General and Thoracic Surgery Azienda Ospedaliera Ospedale di Circolo di Busto Arsizio Presidio Ospedaliero di Saronno, Saronno, Varese, Italy; ² Operative Unit of General Surgery Policlinico di Monza, Monza, Monza Brianza, Italy

We describe a case of carcinoid tumor arising in the Vater’s papilla. The patient is a 52 year-old-woman who had vague abdominal pain with elevated serum alanine transaminase (ALT), aspartate transaminase (AST), γ-glutamyltransferase (GGT), alkaline phosphatase (ALP). Abdominal ultrasound (US), computed tomography (CT), and endoscopic ultrasonography (EUS) revealed an important dilatation of the common bile duct and the main pancreatic duct from the pancreatic head to the tail. A submucosal tumor measuring 18 mm in diameter was detected in the ampulla of Vater by esophagogastroduodenscopy (EGD) and a biopsy was performed. Pathological findings revealed a well-differentiated endocrine tumor with an infiltration into the adjacent tissue like duodenum and pancreatic head. The patient 6 months after a successful Whipple procedure presented to our osservation with liver metastases in both hepatic lobes. The patient was therefore successfully treated with chemotherapy.