Clinical and histological profile of ampullary tumors

Abstract

Background: Ampullary tumors represent a distinct subgroup of tumors. Although studies have been published on periampullary tumors, studies on the ampullary subgroup are rare.

Objective: To study the clinical, histological profile and the various diagnostic and treatment modalities of ampullary tumors

Design: Prospective and retrospective observational study on inpatient of SKIMS, Soura

Results: 36 patients were included in this study, majority of whom were male(55.6%).Mean age at presentation was 55.8yrs. Majority of patients were smokers(50%). Jaundice(71%) was the most common presenting symptom with 27% presenting with cholangitis. Side view duodenoscopy was the main modality for diagnosis with the extramural protruding variant being the most common(4.6%). Histologically, 30 (88.2%) were Adenocarcinomas. Endoscopic biopsy was conclusive in 25 (86%) of patients. Of the patients who required biliary drainage, 73% underwent successful ERCP while of the remaining, 18% patients had to undergo ampullectomy prior to ERCP or PTBD followed by ERCP(9% ). 8.8% of total cases were neuroendocrine tumors (NET) and both patients with NET in whom biliary drainage was required , ampullectomy was necessary prior to ERCP.

Conclusion: Ampullary tumors are a subgroup of periampullary tumors with distinct presentation, diagnostic modalities and treatment outcomes.