Noguchi H, Higashi M, Idichi T, Kurahara H, Mataki Y, Tasaki T, Kitazono I, Ohtsuka T, Tanimoto A. Rare histological subtype of invasive micropapillary carcinoma in the ampulla of Vater: A case report. World J Clin Cases 2021; 9(11): 2671-2678 [PMID: 33889635 DOI: 10.12998/wjcc.v9.i11.2671]
Corresponding Author of This Article
Akihide Tanimoto, MD, PhD, Professor, Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan. akit09@m3.kufm.kagoshima-u.ac.jp
Research Domain of This Article
Pathology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hirotsugu Noguchi, Michiyo Higashi, Takashi Tasaki, Ikumi Kitazono, Akihide Tanimoto, Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan
Tetsuya Idichi, Hiroshi Kurahara, Yuko Mataki, Takao Ohtsuka, Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan
Author contributions: Noguchi H performed the pathological analysis, and wrote the initial draft of the manuscript; Higashi M and Tanimoto A were responsible for the revision of the manuscript for important intellectual content; Idichi T, Kurahara H, Mataki Y and Ohtsuka T were the patient’s surgeons, reviewed the literature and contributed to manuscript drafting; Tasaki T and Kitazono I performed the pathological examination, reviewed the literature and contributed to manuscript drafting; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient’s daughter for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Akihide Tanimoto, MD, PhD, Professor, Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan. akit09@m3.kufm.kagoshima-u.ac.jp
Received: December 16, 2020 Peer-review started: December 16, 2020 First decision: January 10, 2021 Revised: January 18, 2021 Accepted: February 9, 2021 Article in press: February 9, 2021 Published online: April 16, 2021 Processing time: 107 Days and 2.5 Hours
Abstract
BACKGROUND
Carcinoma of the ampulla of Vater is an uncommon ampullo-pancreatobiliary neoplasm, and the most common histological type is adenocarcinoma with a tubular growth pattern. Invasive micropapillary carcinoma (IMPC) is an aggressive variant of adenocarcinoma in several organs that is associated with lymph node metastasis and poor prognosis. IMPC was first described as a histological subtype of breast cancer; however, IMPC of the ampulla of Vater is extremely rare, with only three articles reported in the English literature.
CASE SUMMARY
We have reported a case of IMPC of the ampulla of Vater in an 80-year-old man. Microscopically, the surface area of the carcinoma was composed of tubulopapillary structures mimicking intra-ampullary papillary-tubular neoplasm, and the deep invasive front area exhibited a pattern of IMPC. The carcinoma showed lymphatic invasion and extensive lymph node metastasis. The immunohistochemical study revealed mixed intestinal and gastric/pan-creatobiliary phenotypes.
CONCLUSION
This rare subtype tumor in the ampulla of Vater showed a histologically mixed phenotype and exhibited aggressive behavior.
Core Tip: Only 10 cases of invasive micropapillary carcinoma of the ampulla of Vater have been reported in the English literature. This histological subtype frequently shows lymphatic invasion and lymph node metastasis. Since limited histological studies conducted on this tumor, the present report is helpful for comprehensively understanding its histological and immunohistochemical characteristics.
