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Signet-Ring Cell Carcinoma of the Ampulla of Vater: Report of a Case

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Abstract

Signet-ring cell carcinoma (SRCC) of the ampulla of Vater is uncommon, and only 13 cases have been previously described. We herein report a rare case of a 43-year-old woman with SRCC in the ampulla of Vater. Although this histologic type of cancer generally predicts a poor prognosis elsewhere in the gastrointestinal tract, the present patient has survived with no evidence of recurrence for 7.5 years. The patient was hospitalized for pruritus and jaundice. She underwent a pancreaticoduodenectomy with an extended lymphadenectomy for ampullary carcinoma. This neoplasm was classified as AcdbBi, 2.0 × 1.8 cm, ulcerative type, Panc0, Du2, T2N0M(−), Stage II according to the Japanese Classification on Cancer of the Biliary Tract. Unfortunately, previous reports of ampullary SRCC have been limited to short-term follow-ups with a median period of only 12 months (range, 6–134 months), and long-term survival (more than 5 years) was only documented in two cases without lymph node metastasis (including the present case). In conclusion, the experience gained in the present and previous cases suggests that long-term survival is possible following a curative resection in selected patients with ampullary SRCC without nodal involvement. Due to the lack of sufficient evidence, additional reports are warranted to determine whether SRCC also portends a poor prognosis in patients with ampullary cancer.

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References

  1. C Kunisaki H Shimada M Nomura G Matsuda Y Otsuka H Akiyama (2004) ArticleTitleTherapeutic strategy for signet ring cell carcinoma of the stomach Br J Surg 91 1319–24 Occurrence Handle15376179 Occurrence Handle10.1002/bjs.4637 Occurrence Handle1:STN:280:DC%2BD2cvpsFeiug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  2. Y Adachi K Yasuda M Inomata K Sato N Shiraishi S Kitano (2000) ArticleTitlePathology and prognosis of gastric carcinoma: well versus poorly differentiated type Cancer 89 1418–24 Occurrence Handle11013353 Occurrence Handle10.1002/1097-0142(20001001)89:7<1418::AID-CNCR2>3.0.CO;2-A Occurrence Handle1:STN:280:DC%2BD3cvmslSlsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  3. JP Kim SC Kim HK Yang (1994) ArticleTitlePrognostic significance of signet ring cell carcinoma of the stomach Surg Oncol 3 221–7 Occurrence Handle7834113 Occurrence Handle10.1016/0960-7404(94)90037-X Occurrence Handle1:STN:280:DyaK2M7jsFKgsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  4. A Nissan JG Guillem PB Paty WD Wong AM Cohen (1999) ArticleTitleSignet-ring cell carcinoma of the colon and rectum: a matched control study Dis Colon Rectum 42 1176–80 Occurrence Handle10496558 Occurrence Handle10.1007/BF02238570 Occurrence Handle1:STN:280:DyaK1MvisVyktQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  5. T Anthony R George M Rodriguez-Bigas NJ Petrelli (1996) ArticleTitlePrimary signet-ring cell carcinoma of the colon and rectum Ann Surg Oncol 3 344–8 Occurrence Handle8790846 Occurrence Handle10.1007/BF02305663 Occurrence Handle1:STN:280:DyaK28zot12rsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  6. H Kang JB O'Connell MA Maggard J Sack CY Ko (2005) ArticleTitleA 10-year outcomes evaluation of mucinous and signet-ring cell carcinoma of the colon and rectum Dis Colon Rectum 48 1161–8 Occurrence Handle15868237 Occurrence Handle10.1007/s10350-004-0932-1

    Article  PubMed  Google Scholar 

  7. T Sekoguchi R Mizumoto (1979) ArticleTitleClinicopathological study of papilla of Vater Geka Chiryo 41 1–5

    Google Scholar 

  8. HA Gardner J Matthews PS Ciano (1990) ArticleTitleA signet-ring cell carcinoma of the ampulla of Vater Arch Pathol Lab Med 114 1071–2 Occurrence Handle2171451 Occurrence Handle1:STN:280:DyaK3M%2FisVGhsQ%3D%3D

    PubMed  CAS  Google Scholar 

  9. FM Arnal Monreal MJ Lorenzo Patino F Sacristan G Ghanime Saide (1994) ArticleTitleSignet ring cell carcinoma of the Vater's ampulla Rev Esp Enferm Dig 85 391–3 Occurrence Handle8049111 Occurrence Handle1:STN:280:DyaK2czisFWltg%3D%3D

    PubMed  CAS  Google Scholar 

  10. R Casella WW Rittmann R Meier W Wegmann MK Widmer T Hunger (1994) ArticleTitleSignet ring cell carcinoma of Vater's papilla: a very rare malignancy Helv Chir Acta 60 987–90 Occurrence Handle7876027 Occurrence Handle1:STN:280:DyaK2M7otFaiug%3D%3D

    PubMed  CAS  Google Scholar 

  11. LJ Tseng YT Jao LR Mo (2002) ArticleTitleSignet ring cell carcinoma of major papilla Gastrointest Endosc 56 733 Occurrence Handle12397285 Occurrence Handle10.1016/S0016-5107(02)70126-0

    Article  PubMed  Google Scholar 

  12. T Hara H Kawashima M Ishigooka M Kashiyama S Takanashi Y Hosokawa (2002) ArticleTitleSignet-ring-cell carcinoma of the ampulla of Vater: a case report Hepatogastroenterology 49 561–3 Occurrence Handle11995497

    PubMed  Google Scholar 

  13. S Nabeshima Y Kishihara A Nabeshima S Yamaga M Kinjo S Kashiwagi et al. (2003) ArticleTitlePoorly differentiated adenocarcinoma with signet-ring cells of the Vater's ampulla, without jaundice but with disseminated carcinomatosis Fukuoka Igaku Zasshi 94 235–40 Occurrence Handle14509231

    PubMed  Google Scholar 

  14. N Eriguchi S Aoyagi A Jimi (2003) ArticleTitleSignet-ring cell carcinoma of the ampulla of Vater: report of a case Surg Today 33 467–9 Occurrence Handle12768376 Occurrence Handle10.1007/s10595-002-2509-9

    Article  PubMed  Google Scholar 

  15. JM Ramia A Mansilla J Villar K Muffak D Garrote JA Ferron (2004) ArticleTitleSignet-ring-cell carcinoma of the Vater's ampulla JOP 5 495–7 Occurrence Handle15536289

    PubMed  Google Scholar 

  16. CL Fang JS Chu MC Hsieh MS Wu (2004) ArticleTitleSignet-ring cell carcinoma of the ampulla of Vater J Formos Med Assoc 103 793–6 Occurrence Handle15490032

    PubMed  Google Scholar 

  17. L Li QH Chen JD Sullivan FU Breuer (2004) ArticleTitleSignet-ring cell carcinoma of the ampulla of Vater Ann Clin Lab Sci 34 471–5 Occurrence Handle15648791

    PubMed  Google Scholar 

  18. RC Purohit K Kant N Bhargava N Kothari V Purohit (2005) ArticleTitleSignet ring cell carcinoma of ampulla of Vater in a young adult Indian J Gastroenterol 24 222–3 Occurrence Handle16361773 Occurrence Handle1:STN:280:DC%2BD2Mnnt12muw%3D%3D

    PubMed  CAS  Google Scholar 

  19. M Bloomston M Walker WL Frankel (2006) ArticleTitleRadical resection in signet ring carcinoma of the ampulla of Vater: report of an 11-year survivor Am Surg 72 193–5 Occurrence Handle16536256

    PubMed  Google Scholar 

  20. InstitutionalAuthorNameJapanese Society of Biliary Surgery (2001) Classification of biliary tract carcinoma EditionNumberFirst English edition Kanehara Tokyo 52–65

    Google Scholar 

  21. InstitutionalAuthorNameInternational Union Against Cancer (UICC) (2002) TNM classification of malignant tumours EditionNumber6th ed Wiley-Liss New York 90–2

    Google Scholar 

  22. JD Roder PM Schneider HJ Stein JR Siewert (1996) ArticleTitleNumber of lymph node metastases is significantly associated with survival in patients with radically resected carcinoma of the ampulla of Vater Br J Surg 82 1693–6 Occurrence Handle10.1002/bjs.1800821235

    Article  Google Scholar 

  23. JR Howe DS Klimstra RD Moccia KC Conlon MF Brennan (1998) ArticleTitleFactors predictive of survival in ampullary carcinoma Ann Surg 228 87–94 Occurrence Handle9671071 Occurrence Handle10.1097/00000658-199807000-00013 Occurrence Handle1:STN:280:DyaK1czjsVWntA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  24. J Albores-Saavedra DE Henson DS Klimstra (2000) Malignant epithelial tumors of the ampulla J Rosai (Eds) Atlas of tumor pathology, tumors of the gallbladder, extrahepatic bile ducts, and ampulla of Vater, third series Fascicle 27 Armed Forces Institute of Pathology Washington, DC 259–316

    Google Scholar 

  25. JS Park DS Yoon KS Kim JS Choi WJ Lee HS Chi et al. (2007) ArticleTitleFactors influencing recurrence after curative resection for ampulla of Vater carcinoma J Surg Oncol 95 286–90 Occurrence Handle17326125 Occurrence Handle10.1002/jso.20665

    Article  PubMed  Google Scholar 

  26. HG Beger F Treitschke F Gansauge N Harada N Hiki T Mattfeldt (1999) ArticleTitleTumor of the ampulla of Vater: experience with local or radical resection in 171 consecutively treated patients Arch Surg 134 526–32 Occurrence Handle10323425 Occurrence Handle10.1001/archsurg.134.5.526 Occurrence Handle1:STN:280:DyaK1M3lsFSjtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  27. JR Howe DS Klimstra RD Moccia KC Conlon MF Brennan (1998) ArticleTitleFactors predictive of survival in ampullary carcinoma Ann Surg 228 87–94 Occurrence Handle9671071 Occurrence Handle10.1097/00000658-199807000-00013 Occurrence Handle1:STN:280:DyaK1czjsVWntA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  28. CR Blundell CS Kanun DL Earnest (1982) ArticleTitleBiliary obstruction by heterotopic gastric mucosa at the ampulla of Vater Am J Gastroenterol 77 111–4 Occurrence Handle7072678 Occurrence Handle1:STN:280:DyaL387nvFGjsA%3D%3D

    PubMed  CAS  Google Scholar 

  29. PJ Hoedemaeker (1970) ArticleTitleHeterotopic gastric mucosa in the duodenum Digestion 3 165–73 Occurrence Handle4915587 Occurrence Handle1:STN:280:DyaE3c3mtVyntA%3D%3D Occurrence Handle10.1159/000197027

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Tomotaka Akatsu, Koichi Aiura, Masaki Kitajima & Yuko Kitagawa

  2. Division of Diagnostic Pathology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Kaori Kameyama

  3. Department of Surgery, Nippon Kokan Hospital, Kanagawa, Japan

    Shin Takahashi

Authors
  1. Tomotaka Akatsu
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  2. Koichi Aiura
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  3. Shin Takahashi
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  4. Kaori Kameyama
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  5. Masaki Kitajima
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  6. Yuko Kitagawa
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Akatsu, T., Aiura, K., Takahashi, S. et al. Signet-Ring Cell Carcinoma of the Ampulla of Vater: Report of a Case. Surg Today 37, 1110–1114 (2007). https://doi.org/10.1007/s00595-007-3534-4

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  • DOI: https://doi.org/10.1007/s00595-007-3534-4

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