Mixed neuroendocrine-nonneuroendocrine neoplasm of the ampulla:Four case reports  

作　　者：Yang Wang Zhen Zhang Cheng Wang Shi-Hang Xi Xiao-Ming Wang 

机构地区：[1]Department of Hepatobiliary Surgery,The First Affiliated Hospital of Wannan Medical College,Wuhu 241000,Anhui Province,China

出　　处：《World Journal of Clinical Cases》2022年第7期2268-2274,共7页世界临床病例杂志

基　　金：Supported by Funded Project of"Mountain Climbing"Cultivation Project of Yijishan Hospital of Wannan Medical College,No.KPF2019011

摘　　要：BACKGROUND Mixed neuroendocrine-nonneuroendocrine neoplasm(MiNEN)is a rare tumor that occurs in the gastrointestinal tract and pancreas,usually composed of adenocarcinoma and neuroendocrine carcinoma.MiNEN occurring in ampulla is even rarer.We report 4 cases of MiNEN in ampulla,combined with literature review to summarize the clinical features and treatment of the disease,in order to improve the understanding of the disease.CASE SUMMARY A retrospective analysis was performed in 4 cases of MiNEN of the ampulla diagnosed by pathology from 2014 to 2021.The 4 patients were all male,aged 67-81 years(average 72.25 years).Among them,2 patients had jaundice,1 patient had abdominal pain,and 1 patient had jaundice with abdominal pain as the first symptom.All 4 patients underwent enhanced CT or MRI,which all indicated that the tumors were located in the ampulla.Two patients underwent duodenoscopy,and a biopsy revealed ampullary adenocarcinoma.All 4 patients underwent radical pancreaticoduodenectomy.Four cases were followed up:One patient developed severe complications after the operation,his condition deteriorated,and he survived for 1 mo.In the other 3 patients,tumor recurrence was observed during follow-up,and 2 of them survived for 29 mo and 22 mo respectively.One case survived and is still being followed up.CONCLUSION MiNEN of the ampulla are extremely rare,lacking typical clinical symptoms and imaging features,and are usually diagnosed after postoperative histopathological and immunohistochemical examinations.The main treatment is radical surgical resection,which can be combined with chemotherapy.The best method of diagnosis and treatment needs further research.

关 键 词：AMPULLA Mixed neuroendocrine-nonneuroendocrine neoplasm Pan-creaticoduodenectomy CHEMOTHERAPY Case report 

分 类 号：R735[医药卫生—肿瘤]