Coexistent ampullary squamous cell carcinoma with adenocarcinoma of the pancreatic duct

• Main Authors: Gayatri S Pathak, Sanjay D Deshmukh, Prasanna A Yavalkar, Amrut V Ashturkar
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2011-01-01
• Series: The Saudi Journal of Gastroenterology
• Subjects: Ampulla of Vater; coexistent tumor; ductal adenocarcinoma; squamous cell carcinoma
• Online Access: http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2011;volume=17;issue=6;spage=411;epage=413;aulast=Pathak

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.