A case of signet-ring cell carcinoma of the ampulla of Vater

Abstract

We report a rare case of signet-ring cell carcinoma of the ampulla of Vater. A 59-year-old man admitted for further examination of liver function disorder in a blood chemistry test done due to a fever and appetite loss was found in abdominal ultrasonography (US) and computed tomography (CT) to have a dilated intrahepatic bile duct, common bile duct, and main pancreatic duct. At duodenoscopy, the papilla of Vater was red-dish and enlarged with a small ulcer, and biopsy specimens from the papilla demonstrated signet-ring cell carcinoma. We conducted pylorus-preserving pancreatoduodenectomy based on a diagnosis of signet-ring cell carcinoma of the ampulla of Vater. The tumor was 2 × 3 cm, ulcerated, and protruding. Histopathological findings showed signet-ring cell carcinoma occupied the ampulla of Vater and lymph node metastasis was found within group 1 nodes. The patient is doing well and has no recurrence 1 year and 8 months after surgery. Signet-ring cell carcinoma of the ampulla of Vater is rare, with our case being only the 16th reported in the literature.