Saudi Journal of Gastroenterology
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CASE REPORT
Year : 2011  |  Volume : 17  |  Issue : 6  |  Page : 411-413

Coexistent ampullary squamous cell carcinoma with adenocarcinoma of the pancreatic duct


Department of Pathology and Surgery, Shrimati Kashibai Navale Medical College and General Hospital, Narhe, Pune, India

Correspondence Address:
Gayatri S Pathak
Shrimati Kashibai Navale Medical College and General Hospital, Narhe, Pune - 411 041
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-3767.87184

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Primary squamous cell carcinoma (SCC) of ampulla has seldom been reported. However, metastatic SCC to ampulla of Vater is well known. We report a case of primary SCC of ampulla of Vater coexistent with well-differentiated adenocarcinoma of the distal pancreatic duct. A 50-year-old female presented with evidence of obstructive jaundice. Endoscopic retrograde cholangio-pancreatography revealed bulging papilla with ulcero-infiltrative growth at the ampulla of Vater. An initial endoscopic biopsy of the ampullary mass showed a well-differentiated SCC. The patient underwent Whipple's operation. Thorough sampling of the dilated portion of the pancreatic duct showed presence of well-differentiated adenocarcinoma of the distal pancreatic duct. Immunohistochemical study with synaptophysin and chromogranin was done with negative result, ruling out neuroendocrine differentiation. Also, a detailed clinical, endoscopic and radiological examination was carried out, that excluded the presence of primary SCC elsewhere.


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