Department of Pathology, Forensic Medicine and Cytology, Clinical Hospital Center Split, University School of Medicine, Spinciceva 1, Split 21000, Croatia.
Hepatobiliary Pancreat Dis Int. 2013 Feb;12(1):106-8. doi: 10.1016/s1499-3872(13)60016-8.
The most common tumors in the ampulla of Vater are adenocarcinomas. Although malignant melanoma usually occurs on the skin, it can also arise in the gastrointestinal and biliary tract.
We present a case of a 52-year-old, previously healthy man who presented with painless jaundice.
Clinical examination revealed dilated intrahepatic and extrahepatic bile ducts and pancreatic duct due to the obstructive mass in the ampulla of Vater. The patient underwent pancreaticoduodenectomy and histopathological diagnosis of the resected tumor mass was malignant melanoma. Thorough clinical examination was preformed, but no other primary or metastatic site of melanoma could be found. In the next few months, the patient developed multiple liver metastases and died.
An isolated amelanotic lesion in the ampulla of Vater can be a potential diagnostic pitfall, especially in patients who have had melanoma.
Vater 壶腹最常见的肿瘤是腺癌。虽然恶性黑色素瘤通常发生在皮肤上，但也可发生在胃肠道和胆道。
我们报告了一例 52 岁、既往健康的男性患者，因壶腹占位性病变出现无痛性黄疸。
临床检查发现肝内和肝外胆管及胰管扩张，系壶腹部梗阻所致。患者接受胰十二指肠切除术，切除的肿瘤组织病理学诊断为恶性黑色素瘤。进行了彻底的临床检查，但未发现黑色素瘤的其他原发性或转移性病灶。在接下来的几个月里，患者出现多发肝转移并死亡。
Vater 壶腹的孤立性无色素病变可能是一个潜在的诊断陷阱，特别是对于有黑色素瘤病史的患者。
