Nizam Anjala, Saleem Nadia M, Albakri Tiba A, Saber Amir, Farhan Rabia
Department of Medicine and Surgery, Dubai Academic Health Corporation, Dubai, ARE.
Department of General Surgery, Rashid Hospital, Dubai, ARE.
Cureus. 2023 Feb 19;15(2):e35198. doi: 10.7759/cureus.35198. eCollection 2023 Feb.
A 63-year-old male with multiple co-morbidities presented with a diabetic foot infection which was treated surgically. During admission to the hospital, he developed melena and underwent an endoscopic assessment which revealed an incidental finding of an ampullary mass. The histological analysis of the biopsy revealed ampullary carcinoma with mixed intestinal-type and pancreatobiliary-type features. A magnetic resonance imaging (MRI) of the liver with contrast presented the tumor as an ill-defined small soft tissue lesion measuring 8 x 9 mm in the ampullary region, with multiple lymph nodes in the periportal, peripancreatic, and para-aortic regions. There was no evidence of biliary obstruction. The patient underwent a Whipple procedure with no complications. The final histology report of the specimens taken stated that the tumor is predominantly in the duodenum and focally in the ampulla, and is a well-differentiated neuroendocrine tumor confirmed to be submucosal. The histopathologic and radiologic workup determined the pathological stage classification to be pT3N1, Mx G1.
一名患有多种合并症的63岁男性因糖尿病足感染接受了手术治疗。住院期间，他出现了黑便，并接受了内镜检查，结果意外发现壶腹肿块。活检的组织学分析显示为具有肠型和胰胆管型混合特征的壶腹癌。肝脏增强磁共振成像（MRI）显示肿瘤为壶腹区域一个边界不清的小软组织病变，大小为8×9毫米，在门静脉周围、胰周和主动脉旁区域有多个淋巴结。没有胆道梗阻的证据。患者接受了Whipple手术，未出现并发症。所取标本的最终组织学报告称，肿瘤主要位于十二指肠，局部位于壶腹，是一种确诊为黏膜下的高分化神经内分泌肿瘤。组织病理学和影像学检查确定病理分期分类为pT3N1，Mx G1。
