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Ampullary adenocarcinoma

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https://www.readbyqxmd.com/read/28095024/pathologic-subtypes-of-ampullary-adenocarcinoma-value-of-ampullary-mdct-for-noninvasive-preoperative-differentiation
#1
Aleksandar M Ivanovic, Francesco Alessandrino, Ruzica Maksimovic, Marjan Micev, Slavenko Ostojic, Richard M Gore, Koenraad J Mortele
OBJECTIVE: The purpose of this study was to evaluate the utility of ampullary MDCT in the noninvasive, preoperative differentiation of pancreatobiliary and intestinal subtypes of ampullary adenocarcinoma. MATERIALS AND METHODS: This retrospective study included 32 patients (20 men, 12 women; age range, 41-81 years) with resected ampullary adenocarcinoma who underwent preoperative contrast-enhanced ampullary MDCT. Two radiologists, blinded to pathologic diagnosis of adenocarcinoma subtype, evaluated the presence of seven MDCT features independently...
January 17, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28066666/ct-guided-percutaneous-microwave-ablation-of-pulmonary-malignant-tumors
#2
Wei-Chun Ko, Yee-Fan Lee, Yi-Chang Chen, Ning Chien, Yu-Sen Huang, Yao-Hui Tseng, Jang-Ming Lee, Hsao-Hsun Hsu, Jin-Shing Chen, Yeun-Chung Chang
BACKGROUND: Microwave ablation (MWA) of lung tumors is a new approach for local tumor control. The purpose of this retrospective study was to evaluate the preliminary results of safety and efficacy of MWA with a dynamic frequency range (902-928 MHz) and power (10-32 W) for local tumor control of thoracic malignancies. METHODS: From December 1, 2013 to February 1, 2016, there were total 32 lung tumors among 15 patients (7 men, 8 women, age range 43-82 years, mean 57...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28065885/endoscopic-retrograde-cholangiopancreatography-with-ampullary-biopsy-vs-ercp-alone-a-matched-pairs-controlled-evaluation-of-outcomes-and-complications
#3
Sunil Dacha, Saurabh Chawla, Jai Eun Lee, Steven A Keilin, Qiang Cai, Field F Willingham
BACKGROUND AND AIMS: Biopsy of the ampulla of Vater may be performed to evaluate for ampullary adenomas, suspected ampullary tumors and immunohistological staining for autoimmune pancreatitis. Ampullary biopsies are commonly performed at the time of endoscopic retrograde cholangiopancreatography (ERCP). Due to the well-established complication rate following ERCP, the contribution of ampullary biopsy as a potential independent risk factor would require a controlled comparison. METHODS: A matched-pairs, case-control analysis was performed for patients undergoing ERCP with or without ampullary biopsy...
January 8, 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28058023/laparoscopic-and-endoscopic-co-operative-surgery-for-non-ampullary-duodenal-tumors
#4
Daisuke Ichikawa, Shuhei Komatsu, Osamu Dohi, Yuji Naito, Toshiyuki Kosuga, Kazuhiro Kamada, Kazuma Okamoto, Yoshito Itoh, Eigo Otsuji
AIM: To assess the safety and feasibility of laparoscopic and endoscopic co-operative surgery (LECS) for early non-ampullary duodenal tumors. METHODS: Twelve patients with a non-ampullary duodenal tumor underwent LECS at our hospital. One patient had two mucosal lesions in the duodenum. The indication for this procedure was the presence of duodenal tumors with a low risk for lymph node metastasis. In particular, the tumors included small (less than 10 mm) submucosal tumors (SMT) and epithelial mucosal tumors, such as mucosal cancers or large mucosal adenomas with malignant suspicion...
December 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28054258/transduodenal-ampullectomy-for-ampullary-tumors
#5
Verushka M Mansukhani, Gunjan S Desai, Sasi Mouli, Keval Shirodkar, Rajiv C Shah, Jagannath Palepu
Transduodenal ampullectomy (TDA) is indicated for large ampullary tumors, for presence of dysplasia on endoscopic biopsy, for poor surgical candidates for pancreaticoduodenectomy, and in cases not indicated for endoscopic ampullectomy. Retrospective review of data from 2009 to 2015 revealed 11 patients who underwent TDA. Magnetic resonance imaging cholangiopancreatography (MRI-MRCP), contrast-enhanced computed tomography (CECT) scan, side-viewing endoscopy, and endoscopic ultrasound (EUS) were used for investigating the patients as required...
January 5, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28029673/histopathologic-analysis-of-pancreaticoduodenectomy-specimen
#6
R Dhakhwa, N Kafle
INTRODUCTION: Whipple's Pancreaticoduodenectomy has increasingly been used as an appropriate resectional procedure for tumors of the periampullary region which are pancreatic, periampullary, ampullary and biliary tumors. Our aim was to study the distribution and histopathologic features of these tumors and to examine local trends of periampullary neoplasms resected with a PD. METHODS: A descriptive study was conducted in the department of Pathology, Kathmandu Medical College Teaching Hospital from July 2013 to June 2016...
October 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/27994339/carcinoma-of-the-ampulla-of-vater-associated-with-annular-pancreas
#7
Mallika Tewari, Ashish Verma, H S Shukla
Carcinoma of the ampulla of Vater associated with annular pancreas is a rare entity. Only seven cases have been reported so far in the English literature. We herein report one such case in a 42-year-lady who presented with progressively increasing jaundice and pain in the upper abdomen for past 2 months. A magnetic resonance cholangiopancreaticography (MRCP) and MRI revealed an annular pancreas with an ampullary mass and a dilated CBD. An upper gastrointestinal endoscopic biopsy from the ampullary mass revealed a moderately differentiated adenocarcinoma...
October 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27984236/duodenal-neoplasms-of-gastric-phenotype-an-immunohistochemical-and-genetic-study-with-a-practical-approach-to-the-classification
#8
Risa Hida, Hidetaka Yamamoto, Minako Hirahashi, Reiko Kumagai, Kenichi Nishiyama, Toshihiro Gi, Motohiro Esaki, Takanari Kitazono, Yoshinao Oda
Duodenal neoplasm of gastric phenotype (DNGP) is very rare, and details of its histopathologic, genetic, and biological features are still unclear. Frequent gene mutations in GNAS, KRAS, and APC have been reported in pyloric gland adenomas and fundic gland-type neoplasms (initially reported as low-grade adenocarcinomas) of the stomach. Here we retrospectively analyzed 16 cases of extra-ampullary DNGP (benign to malignant), and we examined the mucin immunoprofile and oncogene mutations (GNAS, KRAS, APC, BRAF, and CTNNB1)...
December 14, 2016: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/27859010/bevacizumab-combined-with-capecitabine-and-oxaliplatin-in-patients-with-advanced-adenocarcinoma-of-the-small-bowel-or-ampulla-of-vater-a-single-center-open-label-phase-2-study
#9
Pat Gulhati, Kanwal Raghav, Rachna T Shroff, Gauri R Varadhachary, Scott Kopetz, Milind Javle, Wei Qiao, Huamin Wang, Jeffrey Morris, Robert A Wolff, Michael J Overman
BACKGROUND: Capecitabine with oxaliplatin (CAPOX) has previously demonstrated clinical activity in patients with small bowel adenocarcinoma (SBA) and ampullary adenocarcinoma (AAC). Herein, the authors conducted a phase 2 trial to evaluate the benefit of adding bevacizumab to CAPOX. METHODS: In this phase 2, single-arm, single-center, open-label study, patients aged ≥18 years with untreated, advanced SBA or AAC were recruited. Patients received capecitabine at a dose of 750 mg/m(2) orally twice daily on days 1 to 14, oxaliplatin at a dose of 130 mg/m(2) intravenously on day 1, and bevacizumab at a dose of 7...
November 14, 2016: Cancer
https://www.readbyqxmd.com/read/27795812/mucins-in-neoplasms-of-pancreas-ampulla-of-vater-and-biliary-system
#10
REVIEW
Dimitrios Moschovis, Giorgos Bamias, Ioanna Delladetsima
Tumors of the pancreas, the ampulla of Vater, and the extrahepatic and intrahepatic bile ducts have significant histological similarities due to the common embryonic origin of the pancreatobiliary system. This obviates the need for discovery of biomarkers with diagnostic and prognostic value for these tumors. Mucins, especially MUC-1, -2, -4 and -5AC, are important candidates for developing into such reliable biomarkers. Increased expression of MUC1 occurs in pancreatic ductal adenocarcinomas and is associated with increased degrees of dysplasia in pancreatic intraepithelial neoplasia (PanIN)...
October 15, 2016: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27739441/non-ampullary-duodenal-carcinomas-clinicopathologic-analysis-of-47-cases-and-comparison-with-ampullary-and-pancreatic-adenocarcinomas
#11
Yue Xue, Alessandro Vanoli, Serdar Balci, Michelle M Reid, Burcu Saka, Pelin Bagci, Bahar Memis, Hyejeong Choi, Nobuyike Ohike, Takuma Tajiri, Takashi Muraki, Brian Quigley, Bassel F El-Rayes, Walid Shaib, David Kooby, Juan Sarmiento, Shishir K Maithel, Jessica H Knight, Michael Goodman, Alyssa M Krasinskas, Volkan Adsay
Literature on non-ampullary-duodenal carcinomas is limited. We analyzed 47 resected non-ampullary-duodenal carcinomas. Histologically, 78% were tubular-type adenocarcinomas mostly gastro-pancreatobiliary type and only 19% pure intestinal. Immunohistochemistry (n=38) revealed commonness of 'gastro-pancreatobiliary markers' (CK7 55, MUC1 50, MUC5AC 50, and MUC6 34%), whereas 'intestinal markers' were relatively less common (MUC2 36, CK20 42, and CDX2 44%). Squamous and mucinous differentiation were rare (in five each); previously, unrecognized adenocarcinoma patterns were noted (three microcystic/vacuolated, two cribriform, one of comedo-like, oncocytic papillary, and goblet-cell-carcinoid-like)...
October 14, 2016: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/27732711/association-of-histopathologic-phenotype-of-periampullary-adenocarcinomas-with-survival
#12
Jennifer L Williams, Carmen K Chan, Paul A Toste, Irmina A Elliott, Charles R Vasquez, Dharma B Sunjaya, Eric A Swanson, Jamie Koo, O Joe Hines, Howard A Reber, David W Dawson, Timothy R Donahue
Importance: Patients with periampullary adenocarcinomas have widely variable survival. These cancers are traditionally categorized by their anatomic location of origin, namely, the duodenum, ampulla, distal common bile duct (CBD), or head of the pancreas. However, they can be alternatively subdivided histopathologically into intestinal or pancreaticobiliary (PB) types, which may more accurately estimate prognosis. Objectives: To identify factors associated with survival in patients with periampullary adenocarcinomas and to compare survival between those having intestinal-type or PB-type cancers originating from the duodenum, ampulla, or distal CBD with those having pancreatic ductal adenocarcinoma (PDAC)...
January 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/27688085/differentiation-and-prognostic-markers-in-ampullary-cancer-role-of-p53-mdm2-cdx2-mucins-and-cytokeratins
#13
Iraklis Perysinakis, Emilia Minaidou, Dimitrios Mantas, George C Sotiropoulos, Vasileia Leontara, Hercules Tsipras, George N Zografos, Ilias Margaris, Gregory Kouraklis
INTRODUCTION: Subclassification of ampullary adenocarcinomas into intestinal and pancreatobiliary type has prognostic and therapeutic implications. Immunohistochemical staining against specific biomarkers has been proven to be a useful adjunct in determining the exact histotype. Furthermore the immunohistochemical profile is suggestive of the molecular pathogenic mechanisms through which the tumor evolved. The aim of this study was to correlate p53, MDM2, CK7, CK20, MUC1, MUC2 and CDX2 expression in ampullary adenocarcinomas with the type of differentiation and patients' survival...
November 2016: Pathology, Research and Practice
https://www.readbyqxmd.com/read/27640104/ampullary-carcinosarcoma-with-osteosarcomatous-small-cell-neuroendocrine-carcinoma-and-conventional-adenocarcinoma-components-first-report
#14
Pallavi Rao, Sadiq S Sikora, Srikanth Narayanaswamy, Nandita Ghosal, Dinesh Kini
Caracinosarcomas are tumours with diverse epithelial and mesenchymal differentiation. They most commonly occur in the female reproductive organs and upper aero digestive tract. They are relatively rare in the gastrointestinal tract and affect the oesophagus most commonly. Ampullary carcinosarcomas are exceptionally rare. We report a case of ampullary carcinosarcoma in a 67-year-old male, with osteosarcomatous, small cell carcinoma and conventional adenocarcinoma components. To the best of our knowledge, this is the first reported case of its kind...
November 2016: Pathology, Research and Practice
https://www.readbyqxmd.com/read/27586202/ampullary-carcinoma-is-often-of-mixed-or-hybrid-histologic-type-an-analysis-of-reproducibility-and-clinical-relevance-of-classification-as-pancreatobiliary-versus-intestinal-in-232-cases
#15
Michelle D Reid, Serdar Balci, Nobuyuki Ohike, Yue Xue, Grace E Kim, Takuma Tajiri, Bahar Memis, Ipek Coban, Anil Dolgun, Alyssa M Krasinskas, Olca Basturk, David A Kooby, Juan M Sarmiento, Shishir K Maithel, Bassel F El-Rayes, Volkan Adsay
Histologic classification of ampullary carcinomas as intestinal versus pancreatobiliary is rapidly becoming a part of management algorithms, with immunohistochemical classification schemes also being devised using this classification scheme as their basis. However, data on the reproducibility and prognostic relevance of this classification system are limited. In this study, five observers independently evaluated 232 resected ampullary carcinomas with invasive component >3 mm. Overall interobserver agreement was 'fair' (κ 0...
September 2, 2016: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/27556089/adjunctive-radiofrequency-ablation-for-the-endoscopic-treatment-of-ampullary-lesions-with-intraductal-extension-with-video
#16
Alejandro L Suarez, Gregory A Coté, B Joseph Elmunzer
Catheter-based radiofrequency ablation (RFA) delivered during endoscopic retrograde cholangiopancreatography (ERCP) may represent a viable treatment option for intraductal extension of ampullary neoplasms, however, clinical experience with this modality is limited. After ampullary resection, 4 patients with intraductal extension underwent adjunctive RFA of the distal bile duct. All patients received a temporary pancreatic stent to reduce the risk of pancreatitis, as well as a plastic biliary stent to prevent biliary obstruction...
July 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27549176/performance-and-prognostic-utility-of-the-92-gene-assay-in-the-molecular-subclassification-of-ampullary-adenocarcinoma
#17
Michael J Overman, Harris S Soifer, Aaron Joel Schueneman, Joe Ensor, Volkan Adsay, Burcu Saka, Nastaran Neishaboori, Robert A Wolff, Huamin Wang, Catherine A Schnabel, Gauri Varadhachary
BACKGROUND: Ampullary adenocarcinoma is a rare gastrointestinal cancer associated with diverse outcomes due to clinical and pathological heterogeneity. Standardized methods to better prognosticate and inform therapeutic selection for ampullary adenocarcinoma are needed. This study explored the novel use and potential prognostic utility of a 92-gene cancer classifier in ampullary adenocarcinomas. METHODS: In this prospectively-defined, blinded study of ampullary adenocarcinoma [N =54; stage T3 or higher (57 %); Grade III (44 %); Node positive (55 %)], the performance of a 92-gene classifier was examined to predict the ampullary subtype that was derived from histomorphological examination of resected ampullary samples...
2016: BMC Cancer
https://www.readbyqxmd.com/read/27543509/differential-expression-of-%C3%AE-catenin-egfr-ck7-ck20-muc1-muc2-and-cdx2-in-intestinal-and-pancreatobiliary-type-ampullary-carcinomas
#18
Iraklis Perysinakis, Emilia Minaidou, Vasileia Leontara, Dimitrios Mantas, Georgios C Sotiropoulos, Hercules Tsipras, George N Zografos, Ilias Margaris, Gregory Kouraklis
INTRODUCTION: The purpose of this study was to associate immunohistochemical expression of β-catenin, EGFR, CK7, CK20, MUC1, MUC2, and CDX2 in ampullary adenocarcinomas with the type of differentiation and prognosis. METHODS: Forty-seven patients with ampullary adenocarcinoma who underwent pancreatoduodenectomy with curative intent from 1997 to 2014 were included in this study. Nine patients with perioperative death were included in the association analysis but excluded from survival analysis...
February 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/27530895/can-endoscopic-papillectomy-be-curative-for-early-ampullary-adenocarcinoma-of-the-ampulla-of-vater
#19
María-Victoria Alvarez-Sanchez, Inés Oria, Olivia B Luna, Jean Pialat, Rodica Gincul, Christine Lefort, Raphael Bourdariat, Fabien Fumex, Vincent Lepilliez, Jean Yves Scoazec, Angel Salgado-Barreira, Anne Isabelle Lemaistre, Bertrand Napoléon
BACKGROUND: The therapeutic role of endoscopic papillectomy (EP) for early ampullary cancer (AC) is still controversial. The aim of the present study was to evaluate the curative potential of EP for early AC and to identify predictors of lymph node metastases (LNMs). METHODS: We retrospectively reviewed 173 patients who were prospectively included in a database and who underwent EP between 1999 and 2013. Adenocarcinoma was present in 28 resected specimens. An additional surgery was proposed in cases of duodenal submucosal infiltration, duct ingrowth, R1 resection or lymphovascular invasion...
August 16, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27517148/kras-mutation-as-a-prognostic-factor-in-ampullary-adenocarcinoma-a-meta-analysis-and-review
#20
Bum Jun Kim, Hyun Joo Jang, Jung Han Kim, Hyeong Su Kim, Jin Lee
Ampullary adenocarcinoma (A-AC) is a rare malignancy arising from the ampulla of Vater. KRAS mutation is detected in 30-40% of patients with A-AC, but its clinical implication and prognostic value are not well described. We conducted this meta-analysis to investigate the association between KRAS mutation and prognosis in patients with A-AC. We searched Pubmed, MEDLINE, EMBASE, and the Cochrane Library databases for articles including following terms in their titles, abstracts, or keywords: 'ampullary or periampullary or ampulla of vater', 'cancer or carcinoma', and 'KRAS'...
September 6, 2016: Oncotarget
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