Figure 100.3. Contrast-enhanced helical computed tomography scan (A) demonstrating a regionally advanced adenocarcinoma of the ampulla of Vater.
Figure 100.3. Contrast-enhanced helical computed tomography scan (A) demonstrating a regionally advanced adenocarcinoma of the ampulla of Vater.

Figure 100.3

Contrast-enhanced helical computed tomography scan (A) demonstrating a regionally advanced adenocarcinoma of the ampulla of Vater. Metastatic disease is strongly suspected in the large low-density retropancreatic lymph node (arrow), which lies just medial to the primary tumor, lateral to the inferior vena cava, and posterior to the pancreatic head. The primary ampullary adenocarcinoma is identified by the open arrow (which is within the gallbladder). This patient had no evidence of distant organ metastatic disease and was treated with a program of neoadjuvant chemoradiation. The delay in surgery resulting from the decision to deliver chemoradiation necessitated the placement of an endobiliary stent (B). Four weeks following the completion of chemoradiation restaging studies demonstrated no evidence of disease progression; therefore, pancreaticoduodenectomy was performed. Final pathologic evaluation of the resected specimen demonstrated moderately differentiated adenocarcinoma of the ampulla of Vater with extensive treatment effect; metastatic disease was found in five of 13 regional lymph nodes.

From: Chapter 100, Neoplasms of the Ampulla of Vater

Cover of Holland-Frei Cancer Medicine
Holland-Frei Cancer Medicine. 5th edition.
Bast RC Jr, Kufe DW, Pollock RE, et al., editors.
Hamilton (ON): BC Decker; 2000.
© 2000, BC Decker Inc.

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