Department of Pathology and Surgery, Shrimati Kashibai Navale Medical College and General Hospital, Narhe, Pune, India.
Saudi J Gastroenterol. 2011 Nov-Dec;17(6):411-3. doi: 10.4103/1319-3767.87184.
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.
壶腹原发性鳞状细胞癌（SCC）很少见。然而，转移性 SCC 至 Vater 壶腹是众所周知的。我们报告了一例 Vater 壶腹原发性 SCC 合并远端胰管分化良好的腺癌。一位 50 岁女性因阻塞性黄疸就诊。内镜逆行胰胆管造影显示壶腹有隆起的乳头，呈溃疡性浸润性生长。壶腹肿块的初次内镜活检显示分化良好的 SCC。患者接受了 Whipple 手术。对扩张的胰管进行彻底取样，显示存在远端胰腺导管分化良好的腺癌。用突触素和嗜铬粒蛋白进行免疫组织化学研究，结果为阴性，排除了神经内分泌分化。此外，还进行了详细的临床、内镜和影像学检查，排除了其他部位存在原发性 SCC 的可能性。
