A Case of Carcinoma of Ampulla of Vater Metastasized to the Finger / 대한피부과학회지

Skin metastasis from internal malignancy is relatively rare. Skin metastasis from biliary tract cancer is known to be extremely uncommon (around 0.4~0.7%). In most cases, biliary tract cancer metastasizes into neighboring organs or other internal organs, but rarely into the skin. The authors have experienced a case of skin metastasis into a finger of a patient with carcinoma of Ampulla of Vater. This is thought to be the first case reported in Korea.

A case of SIADH associated with carcinoma of the ampulla of Vater / 대한내과학회지

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is one of the most common causes of hyponatremia and results from inappropriate release of antidiuretic hormone (ADH). SIADH may be caused by a variety of malignant tumors, including central nervous system disorders, intrathoracic disorders and various pharmacologic agents. We experienced a case of SIADH associated with carcinoma of the ampulla of Vater. A 73-year-old man was admitted to hospital with abdominal pain and hiccup. Laboratory findings showed that the serum sodium concentration and serum osmolarity were extremely low, while the urine sodium concentration and urine osmolarity were inappropriately high, and the patient was diagnosed with SIADH. Endoscopy showed an ill-defined nodular ampulla of Vater and a biopsy revealed a carcinoma. Resection of the ampullary carcinoma corrected the abnormal sodium levels and restored the laboratory findings to normal. The normal conditions have been continuous for 6 months. To our knowledge, this is the first case of SIADH caused by an ampullary carcinoma.

THE ENDOSCOPIC ULTRASONOGRAPHY ASSESSMENT IN THE PREOPERATIVE STAGING FOR CARCINOMA OF AMPULLA OF VATER AND EXTRAHEPATIC BILE DUCT / 中华消化内镜杂志

In order to investigate the lesion' s extention and the infiltrated deepth and the metastasis of the tumors preoperatively ,endoscopic ultrasonography (EUS) was performed in 28 patients with ampullary carcinoma and 18 patients with extrahepatic bile duct carcinoma. forty six patients underwent surgical ex- plorations. A radical resection with detailed pathological study was done for 22 resectable cases of ampullary carcinoma and all the 18 cases of extrahepatic bile duct carcinoma. Carcinoma of ampulla of Vater and ex- trahepatic bile duct were assessed and staged preoperatively according to the TNM staging system. The re- sults of EUS were compared with surgical explorations and pathological findings for evaluating the accuracy of preoperative staging of EUS. The accurate rate of EUS in assessing the extent of cancer invasion was 8l.8% for ampullary carcinoma, 72. 2% for extrahepatic bile duct carcinoma. The accuracy of EUS in pre- dicting regional lymph node metastasis was 59% for ampullary carcinoma , and 61.6% for extrahepatic bile duct carcionoma. invasion of portal vein was correctly predicted by EUS in 2 out of 3 patients of ampullary carcinoma. All the 3 cases of liver metastasis were not detected by EUS. EUS is a more accurate diagnostic method in judgement of invasive extent of ampullory carcinoma and extrahepatic bile duct carcinoma preop- eratively , but less accurate for metastasis of the tumors.