Luka Ferenc, Székely Iván, Máj Csilla, Szántó Imre, Hamvas Balázs, Altorjay Aron
Fejér Megyei Szent György Kórház, Székesfehérvár, Altalános Sebészeti Osztály.
Magy Seb. 2005 Oct;58(5):320-3.
Carcinoid tumor of the papilla of Vater is extreme rare. Only 73 cases have been reported in the world literature to date and only 1 case in Hungary. This tumor differs clinically and has a different prognosis from other carcinoid tumors of the gastrointestinal tract as it is more aggressive. The clinical feature is determined by the expansion and infiltrative nature of the tumor. Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic biopsy (EB) are the most accurate methods of diagnosis, while endoscopic ultrasonography (EUS) is the most important method to decide the surgical strategy. Depending on the tumor size and the grade of invasion of other structures surgical treatment can be local excision or radical resection. We present a 67-year-old female patient with obstructive jaundice, caused by carcinoid tumor of the papilla of Vater. Diagnosis was obtained by ERCP and EB. Because of the signs of local invasion emerging on EUS a pylorus preserving pancreatoduodenectomy was performed. Six months after the operation there is no evidence of recurrence.
Vater乳头类癌极为罕见。迄今为止,世界文献中仅报道了73例,匈牙利仅有1例。该肿瘤在临床上与其他胃肠道类癌不同,预后也不同,因为它更具侵袭性。临床特征取决于肿瘤的扩展和浸润性质。内镜逆行胰胆管造影(ERCP)和内镜活检(EB)是最准确的诊断方法,而内镜超声检查(EUS)是决定手术策略的最重要方法。根据肿瘤大小和对其他结构的侵犯程度,手术治疗可以是局部切除或根治性切除。我们报告一例67岁女性患者,因Vater乳头类癌导致梗阻性黄疸。通过ERCP和EB确诊。由于EUS显示有局部侵犯迹象,遂行保留幽门的胰十二指肠切除术。术后六个月无复发迹象。