Diagnosis and Treatment of a Vaterian Ampulloma: A Rare Case Report
MERGHAD Hatim
*
Department of Digestive Surgical Oncology, National Institute of Oncology, Rabat, Morocco.
ABOUKER Ibrahim
Department of Digestive Surgical Oncology, National Institute of Oncology, Rabat, Morocco.
BOUFELOUSSEN Mohammed
Department of Digestive Surgical Oncology, National Institute of Oncology, Rabat, Morocco.
ASATASH Yousra
Department A of Surgery, IBN SINA university hospital, Rabat, Morocco.
ZAHRAOUI Anass
Department A of Surgery, IBN SINA university hospital, Rabat, Morocco.
EL MOUATASSIM Zakaria
Department of Digestive Surgical Oncology, National Institute of Oncology, Rabat, Morocco.
LAHNAOUI Oumaima
Department of Digestive Surgical Oncology, National Institute of Oncology, Rabat, Morocco.
SOUADKA Amine
Department of Digestive Surgical Oncology, National Institute of Oncology, Rabat, Morocco.
MAJBAR Mohammed Anass
Department of Digestive Surgical Oncology, National Institute of Oncology, Rabat, Morocco.
BENKABBOU Amine
Department of Digestive Surgical Oncology, National Institute of Oncology, Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Ampullary neuroendocrine neoplasms (Amp-NENs) are relatively uncommon histological tumors within the Vaterian ampulla of the duodenum. Duodenal neuroendocrine neoplasms (NENs) are a rare entity, but the incidence has been increasing during the last few years. Amp-NENs exhibit distinct clinical, histologic, and immunohistochemical features compared to non-ampullary duodenal NENs. Clinical symptoms are complicated and can be hard to differentiate from other tumors of the duodenum. We report the case of a 45-year-old patient admitted with symptoms of jaundice and anemia, diagnosed with a grade 2 Ampullary neuroendocrine neoplasm. Detecting duodenal NENs is based on imaging tests, endoscopy, and biomarker evaluation. Generally, the main therapeutic strategy is surgical excision, especially for localized tumors. Clinicians should be aware of the potential for ampullary neuroendocrine neoplasms because this entity is not sufficiently well known and is quite rare. Further research is necessary to enhance therapeutic alternatives and detection techniques to improve diagnosis and therapy. This manuscript sheds light on a rare Ampullary NEN, providing information about the patient’s case and a learning point for clinicians. Such tumor presentations can often mimic other common conditions. Similar symptoms make the physicians overlook this type of uncommon tumor. It can be used as a reference for future studies related to this field. Moreover, it emphasizes the need to develop alternative treatment and investigation techniques to reach the diagnosis more conveniently.
Keywords: Ampullary neuroendocrine neoplasia, duodenal neuroendocrine neoplasms, jaundice, ampulla of Vater