Heterogeneous group of malignant epithelial neoplasms (adenocarcinoma) arising from ampulla of Vater
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Radiographic Findings
Fluoroscopic Findings
Angiographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Nagino M et al: Clinical practice guidelines for the management of biliary tract cancers 2019: the 3rd English edition. J Hepatobiliary Pancreat Sci. 28(1):26-54, 2021
Paluri R et al: Ampullary cancer. StatPearls, 2021
Angthong W et al: Differentiation of benign and malignant ampullary obstruction by multi-row detector CT. Jpn J Radiol. 36(8):477-88, 2018
Amr B et al: Systematic evaluation of radiological findings in the assessment of resectability of peri-ampullary cancer by CT using different contrast phase protocols. Clin Radiol. 72(8):691.e11-7, 2017
Zhao DZ et al: Multi-detector spiral CT diagnosis of common bile duct ampullary carcinoma. Eur Rev Med Pharmacol Sci. 21(16):3549-53, 2017
Dusunceli Atman E et al: MRI findings of intrinsic and extrinsic duodenal abnormalities and variations. Korean J Radiol. 16(6):1240-52, 2015
Raman SP et al: Abnormalities of the distal common bile duct and ampulla: diagnostic approach and differential diagnosis using multiplanar reformations and 3D imaging. AJR Am J Roentgenol. 203(1):17-28, 2014
Jang KM et al: Added value of diffusion-weighted MR imaging in the diagnosis of ampullary carcinoma. Radiology. 266(2):491-501, 2013
Westgaard A et al: Intestinal-type and pancreatobiliary-type adenocarcinomas: how does ampullary carcinoma differ from other periampullary malignancies? Ann Surg Oncol. 20(2):430-9, 2013
Chung YE et al: Differentiation of benign and malignant ampullary obstructions on MR imaging. Eur J Radiol. 80(2):198-203, 2011
Chung YE et al: Differential features of pancreatobiliary- and intestinal-type ampullary carcinomas at MR imaging. Radiology. 257(2):384-93, 2010
Barauskas G et al: Tumor-related factors and patient's age influence survival after resection for ampullary adenocarcinoma. J Hepatobiliary Pancreat Surg. 15(4):423-8, 2008
Carter JT et al: Tumors of the ampulla of vater: histopathologic classification and predictors of survival. J Am Coll Surg. 207(2):210-8, 2008
Chen WX et al: Multiple imaging techniques in the diagnosis of ampullary carcinoma. Hepatobiliary Pancreat Dis Int. 7(6):649-53, 2008
O'Connell JB et al: Survival after resection of ampullary carcinoma: a national population-based study. Ann Surg Oncol. 15(7):1820-7, 2008
Schirmacher P et al: Ampullary adenocarcinoma - differentiation matters. BMC Cancer. 8:251, 2008
Singh S et al: Palliative surgical bypass for unresectable periampullary carcinoma. Hepatobiliary Pancreat Dis Int. 7(3):308-12, 2008
Smith RA et al: Prognosis of resected ampullary adenocarcinoma by preoperative serum CA19-9 levels and platelet-lymphocyte ratio. J Gastrointest Surg. 12(8):1422-8, 2008
Ahualli J: The double duct sign. Radiology. 244(1):314-5, 2007
Sugita R et al: Periampullary tumors: high-spatial-resolution MR imaging and histopathologic findings in ampullary region specimens. Radiology. 231(3):767-74, 2004
Clements WM et al: Ampullary carcinoid tumors: rationale for an aggressive surgical approach. J Gastrointest Surg. 7(6):773-6, 2003
Duffy JP et al: Improved survival for adenocarcinoma of the ampulla of Vater: fifty-five consecutive resections. Arch Surg. 138(9):941-8; discussion 948-50, 2003
Handra-Luca A et al: Adenomyoma and adenomyomatous hyperplasia of the Vaterian system: clinical, pathological, and new immunohistochemical features of 13 cases. Mod Pathol. 16(6):530-6, 2003
Lindell G et al: Management of cancer of the ampulla of Vater: does local resection play a role? Dig Surg. 20(6):511-5, 2003
Martin JA et al: Ampullary adenoma: clinical manifestations, diagnosis, and treatment. Gastrointest Endosc Clin N Am. 13(4):649-69, 2003
Nakano K et al: Combination therapy of resection and intraoperative radiation for patients with carcinomas of extrahepatic bile duct and ampulla of Vater: prognostic advantage over resection alone? Hepatogastroenterology. 50(52):928-33, 2003
Smith TR et al: Prolapse of the common bile duct with small ampullary villous adenocarcinoma into third part of the duodenum. AJR Am J Roentgenol. 181(2):599-600, 2003
Trimbath JD et al: Attenuated familial adenomatous polyposis presenting as ampullary adenocarcinoma. Gut. 52(6):903-4, 2003
Irie H et al: MR imaging of ampullary carcinomas. J Comput Assist Tomogr. 26(5):711-7, 2002
Jordan PH Jr et al: Treatment of ampullary villous adenomas that may harbor carcinoma. J Gastrointest Surg. 6(5):770-5, 2002
Kaiser A et al: The adenoma-carcinoma sequence applies to epithelial tumours of the papilla of Vater. Z Gastroenterol. 40(11):913-20, 2002
Kim JH et al: Differential diagnosis of periampullary carcinomas at MR imaging. Radiographics. 22(6):1335-52, 2002
Rodriguez C et al: How accurate is preoperative diagnosis by endoscopic biopsies in ampullary tumours? Rev Esp Enferm Dig. 94(10):585-92, 2002
Skordilis P et al: Is endosonography an effective method for detection and local staging of the ampullary carcinoma? A prospective study. BMC Surg. 2(1):1, 2002
Yoshida T et al: Hepatectomy for liver metastasis from ampullary cancer after pancreatoduodenectomy. Hepatogastroenterology. 49(43):247-8, 2002
Eriguchi N et al: Carcinoma of the ampulla of Vater associated with other organ malignancies. Kurume Med J. 48(4):255-9, 2001
Hirata S et al: Periampullary choledochoduodenal fistula in ampullary carcinoma. J Hepatobiliary Pancreat Surg. 8(2):179-81, 2001
Nikfarjam M et al: Local resection of ampullary adenocarcinomas of the duodenum. ANZ J Surg. 71(9):529-33, 2001
Wagle PK et al: Pancreaticoduodenectomy for periampullary carcinoma. Indian J Gastroenterol. 20(2):53-5, 2001
Wittekind C et al: Adenoma of the papilla and ampulla--premalignant lesions? Langenbecks Arch Surg. 386(3):172-5, 2001
Yeo CJ et al: Periampullary adenocarcinoma: analysis of 5-year survivors. Ann Surg. 227(6):821-31, 1998
Talamini MA et al: Adenocarcinoma of the ampulla of Vater. A 28-year experience. Ann Surg. 225(5):590-9; discussion 599-600, 1997
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KEY FACTS
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TERMINOLOGY
Definitions
Heterogeneous group of malignant epithelial neoplasms (adenocarcinoma) arising from ampulla of Vater
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Radiographic Findings
Fluoroscopic Findings
Angiographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Nagino M et al: Clinical practice guidelines for the management of biliary tract cancers 2019: the 3rd English edition. J Hepatobiliary Pancreat Sci. 28(1):26-54, 2021
Paluri R et al: Ampullary cancer. StatPearls, 2021
Angthong W et al: Differentiation of benign and malignant ampullary obstruction by multi-row detector CT. Jpn J Radiol. 36(8):477-88, 2018
Amr B et al: Systematic evaluation of radiological findings in the assessment of resectability of peri-ampullary cancer by CT using different contrast phase protocols. Clin Radiol. 72(8):691.e11-7, 2017
Zhao DZ et al: Multi-detector spiral CT diagnosis of common bile duct ampullary carcinoma. Eur Rev Med Pharmacol Sci. 21(16):3549-53, 2017
Dusunceli Atman E et al: MRI findings of intrinsic and extrinsic duodenal abnormalities and variations. Korean J Radiol. 16(6):1240-52, 2015
Raman SP et al: Abnormalities of the distal common bile duct and ampulla: diagnostic approach and differential diagnosis using multiplanar reformations and 3D imaging. AJR Am J Roentgenol. 203(1):17-28, 2014
Jang KM et al: Added value of diffusion-weighted MR imaging in the diagnosis of ampullary carcinoma. Radiology. 266(2):491-501, 2013
Westgaard A et al: Intestinal-type and pancreatobiliary-type adenocarcinomas: how does ampullary carcinoma differ from other periampullary malignancies? Ann Surg Oncol. 20(2):430-9, 2013
Chung YE et al: Differentiation of benign and malignant ampullary obstructions on MR imaging. Eur J Radiol. 80(2):198-203, 2011
Chung YE et al: Differential features of pancreatobiliary- and intestinal-type ampullary carcinomas at MR imaging. Radiology. 257(2):384-93, 2010
Barauskas G et al: Tumor-related factors and patient's age influence survival after resection for ampullary adenocarcinoma. J Hepatobiliary Pancreat Surg. 15(4):423-8, 2008
Carter JT et al: Tumors of the ampulla of vater: histopathologic classification and predictors of survival. J Am Coll Surg. 207(2):210-8, 2008
Chen WX et al: Multiple imaging techniques in the diagnosis of ampullary carcinoma. Hepatobiliary Pancreat Dis Int. 7(6):649-53, 2008
O'Connell JB et al: Survival after resection of ampullary carcinoma: a national population-based study. Ann Surg Oncol. 15(7):1820-7, 2008
Schirmacher P et al: Ampullary adenocarcinoma - differentiation matters. BMC Cancer. 8:251, 2008
Singh S et al: Palliative surgical bypass for unresectable periampullary carcinoma. Hepatobiliary Pancreat Dis Int. 7(3):308-12, 2008
Smith RA et al: Prognosis of resected ampullary adenocarcinoma by preoperative serum CA19-9 levels and platelet-lymphocyte ratio. J Gastrointest Surg. 12(8):1422-8, 2008
Ahualli J: The double duct sign. Radiology. 244(1):314-5, 2007
Sugita R et al: Periampullary tumors: high-spatial-resolution MR imaging and histopathologic findings in ampullary region specimens. Radiology. 231(3):767-74, 2004
Clements WM et al: Ampullary carcinoid tumors: rationale for an aggressive surgical approach. J Gastrointest Surg. 7(6):773-6, 2003
Duffy JP et al: Improved survival for adenocarcinoma of the ampulla of Vater: fifty-five consecutive resections. Arch Surg. 138(9):941-8; discussion 948-50, 2003
Handra-Luca A et al: Adenomyoma and adenomyomatous hyperplasia of the Vaterian system: clinical, pathological, and new immunohistochemical features of 13 cases. Mod Pathol. 16(6):530-6, 2003
Lindell G et al: Management of cancer of the ampulla of Vater: does local resection play a role? Dig Surg. 20(6):511-5, 2003
Martin JA et al: Ampullary adenoma: clinical manifestations, diagnosis, and treatment. Gastrointest Endosc Clin N Am. 13(4):649-69, 2003
Nakano K et al: Combination therapy of resection and intraoperative radiation for patients with carcinomas of extrahepatic bile duct and ampulla of Vater: prognostic advantage over resection alone? Hepatogastroenterology. 50(52):928-33, 2003
Smith TR et al: Prolapse of the common bile duct with small ampullary villous adenocarcinoma into third part of the duodenum. AJR Am J Roentgenol. 181(2):599-600, 2003
Trimbath JD et al: Attenuated familial adenomatous polyposis presenting as ampullary adenocarcinoma. Gut. 52(6):903-4, 2003
Irie H et al: MR imaging of ampullary carcinomas. J Comput Assist Tomogr. 26(5):711-7, 2002
Jordan PH Jr et al: Treatment of ampullary villous adenomas that may harbor carcinoma. J Gastrointest Surg. 6(5):770-5, 2002
Kaiser A et al: The adenoma-carcinoma sequence applies to epithelial tumours of the papilla of Vater. Z Gastroenterol. 40(11):913-20, 2002
Kim JH et al: Differential diagnosis of periampullary carcinomas at MR imaging. Radiographics. 22(6):1335-52, 2002
Rodriguez C et al: How accurate is preoperative diagnosis by endoscopic biopsies in ampullary tumours? Rev Esp Enferm Dig. 94(10):585-92, 2002
Skordilis P et al: Is endosonography an effective method for detection and local staging of the ampullary carcinoma? A prospective study. BMC Surg. 2(1):1, 2002
Yoshida T et al: Hepatectomy for liver metastasis from ampullary cancer after pancreatoduodenectomy. Hepatogastroenterology. 49(43):247-8, 2002
Eriguchi N et al: Carcinoma of the ampulla of Vater associated with other organ malignancies. Kurume Med J. 48(4):255-9, 2001
Hirata S et al: Periampullary choledochoduodenal fistula in ampullary carcinoma. J Hepatobiliary Pancreat Surg. 8(2):179-81, 2001
Nikfarjam M et al: Local resection of ampullary adenocarcinomas of the duodenum. ANZ J Surg. 71(9):529-33, 2001
Wagle PK et al: Pancreaticoduodenectomy for periampullary carcinoma. Indian J Gastroenterol. 20(2):53-5, 2001
Wittekind C et al: Adenoma of the papilla and ampulla--premalignant lesions? Langenbecks Arch Surg. 386(3):172-5, 2001
Yeo CJ et al: Periampullary adenocarcinoma: analysis of 5-year survivors. Ann Surg. 227(6):821-31, 1998
Talamini MA et al: Adenocarcinoma of the ampulla of Vater. A 28-year experience. Ann Surg. 225(5):590-9; discussion 599-600, 1997
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