Schürmann G, Betzler M, Waldherr R
Chirurgische Klinik, Universität Heidelberg.
Chirurg. 1988 Oct;59(10):670-5.
We report on a patient with a carcinoid tumour of the ampulla of Vater and review the 33 known cases of the literature with regard to clinical presentation, morphology and therapy. As it is apparent from the location of the tumour, obstructive jaundice, pancreatitis and nonspecific upper abdominal complaints are the most frequent symptoms. The ampullary carcinoid belongs histogenetically to the APUD cell system with the ability of multiple endocrine activity. The expression of somatostatin peptide and neuron-specific enolase are the most common histopathological findings. A systemic function of these hormones, however, has not yet been shown. For diagnostic purposes in surgical pathology we found synaptophysin and chromogranin A to be important markers. For surgical treatment, partial duodenopancreatectomy remains the current therapy of choise, if the tumour exceeds two centimeters in diameter.
我们报告了1例 Vater 壶腹类癌患者,并回顾了文献中已知的33例病例的临床表现、形态学和治疗情况。从肿瘤的位置可以明显看出,梗阻性黄疸、胰腺炎和非特异性上腹部不适是最常见的症状。壶腹类癌在组织发生学上属于具有多种内分泌活性能力的 APUD 细胞系统。生长抑素肽和神经元特异性烯醇化酶的表达是最常见的组织病理学发现。然而,这些激素的全身性功能尚未得到证实。在外科病理学的诊断中,我们发现突触素和嗜铬粒蛋白 A 是重要的标志物。对于手术治疗,如果肿瘤直径超过两厘米,十二指肠胰腺部分切除术仍是目前的首选治疗方法。