Chen C M, Wu C S, Tasi S L, Hung C F, Chen T C
Department of Hepatogastroenterology, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1996 Sep;19(3):253-7.
A wide variety of neoplastic lesions may involve the ampulla of Vater, but squamous cell carcinoma has not been reported. Here we report a case of squamous cell carcinoma of papilla Vater. A 72-year-old Chinese female was manifested by obstructive jaundice and biliary tract infection. Duodenoscopic study revealed a polypoid mass with deep and broad ulcer on the ampulla of Vater. Histological examination revealed a metastatic squamous cell carcinoma. The gynecologist had examined the patient carefully and revealed a negative tumor survey. Other sources were also intensively studied but which revealed nothing. The patient developed biliary tree infection after endoscopic retrograde cholangiopancreatic study so that percutaneous transhepatic cholangiography & drainage was performed. Pseudomonas aeruginosa and Enterococcus were cultured from the drainaged bile. Radiotherapy was used and the bleeding was halted temporarily but the patient later expired due to persistent bleeding.
多种肿瘤性病变可能累及 Vater 壶腹，但鳞状细胞癌尚未见报道。在此我们报告 1 例 Vater 乳头鳞状细胞癌。1 名 72 岁中国女性表现为梗阻性黄疸和胆道感染。十二指肠镜检查发现 Vater 壶腹有一息肉样肿物，伴有深而宽的溃疡。组织学检查显示为转移性鳞状细胞癌。妇科医生对患者进行了仔细检查，肿瘤检查结果为阴性。对其他可能来源也进行了深入研究，但未发现异常。患者在内镜逆行胰胆管造影检查后发生胆道感染，因此进行了经皮肝穿刺胆管造影及引流。引流胆汁培养出铜绿假单胞菌和肠球菌。采用了放疗，出血暂时停止，但患者后来因持续出血死亡。
