CASE REPORT: PDF OnlyCoexistence of Large Cell Neuroendocrine Carcinoma and Adenocarcinoma of the Ampulla of VaterLiu, Shih-Hao*; Tsay, Shyh-HawAuthor Information Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C. *Correspondence to: Dr Shih-Hao Liu, Department of Pathology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C. E-mail: [email protected] Received: December 24, 2007; • Accepted: May 23, 2008. Journal of the Chinese Medical Association: October 2008 - Volume 71 - Issue 10 - p 536-540 doi: 10.1016/S1726-4901(08)70164-3 Metrics Abstract We report a case of coexisting poorly differentiated endocrine carcinoma and conventional adenocarcinoma in the ampulla of Vater. A 70-year-old female had a recent history of symptoms and signs related to obstructive jaundice. An initial endoscopic biopsy of the ampulla of Vater showed a poorly differentiated endocrine carcinoma in the lamina propria of duodenal mucosa. The tumor could also be categorized into large cell neuroendocrine carcinoma under the WHO classification of pulmonary neuroendocrine tumors. The patient underwent Whipple's operation. After thorough microscopic examination of the ampulla of Vater, we incidentally found another conventional adenocarcinoma on the inner side of the duodenal papilla, and the tumor collided with the aforementioned carcinoma. The association of neuroendocrine tumor and adenocarcinoma has been reported in a few case reports and a small series. We also review the literature concerning large cell neuroendocrine carcinoma in this area. © 2008 by Lippincott Williams & Wilkins, Inc.