Clinical Endoscopy

A Case of Signet-ring Cell Carcinoma of the Ampulla of Vater: Dong Ik Kim, M.D., Sang Wook Park, M.D., Geum Soo Lee, M.D., Geyong Yun Jung, M.D., Hyun Jin Jung, M.D., Hyeung Cheol Moon, M.D., Gun Young Hong, M.D. and Yeun Keun Lim, M.D.; Korean J Gastrointest Endosc 2010;41(4):251-254. Published online October 30, 2010

Abstract PDF: Signet-ring cell carcinoma of the ampulla of Vater is so rare that only 16 cases have been reported. Here we report a case of a 47-year-old man with signet-ring cell carcinoma in the ampulla of Vater. The patient was hospitalized for right upper quadrant abdominal pain and jaundice which had developed 10 days prior. Computed tomography (CT) and ultrasonography (US) revealed dilatation of the common bile duct and the intrahepatic bile duct. On duodenoscopy, a bulging mass with an irregular margin in the major papilla was noted. Histologic findings showed a signet-ring cell carcinoma. Surgical resection was not done because lymph node metastasis was noted during the operation. Hence, conservative treatment including chemotherapy and bile drainage was done. (Korean J Gastrointest Endosc 2010;41:251-254)

2,475 View
9 Download

The Differential Diagnosis and Prognosis of an Ampulla of Vater Cancer with a Grossly Normal Appearance: Ji Bong Jeong, M.D., Yong-Tae Kim, M.D.*, Yong Jin Jung, M.D., Ji Won Kim, M.D., Byung Kwan Kim, M.D., Kook Lae Lee, M.D., Ji Kon Ryu, M.D.* and Yong Bum Yoon, M.D.*; Korean J Gastrointest Endosc 2008;37(3):185-191. Published online September 30, 2008

Abstract PDF: Background
/Aims: The purpose of this study was to determine the clinical parameters for a differential diagnosis between a malignant and benign stricture of the ampulla of Vater with a grossly normal appearance and to evaluate the diagnostic accuracy of the use of an endoscopic biopsy for the prognosis of ampulla of Vater cancers. Methods: Medical records and cholangiograms were retrospectively reviewed. In order to determine the clinical parameters useful for a differential diagnosis, clinical manifestations, laboratory findings and the common bile duct diameter were compared between malignant and benign strictures. The diagnostic accuracy of the use of an endoscopic biopsy and the clinical features of patients with an ampulla of Vater cancer were analyzed. The survival rate after management was also evaluated. Results: Nine patients with a benign stricture and 15 patients with a malignant stricture were included in this study. The levels of serum bilirubin, alkaline phosphatase and alanine aminotransferase were significantly higher in patients with a malignant stricture than in patients with a benign stricture (p＜0.05). Of the patients who underwent surgical management, 93% had stage I or II disease. All of the patients were alive up to a mean follow-up period of 50 months. Conclusions: Liver function tests and the use of an endoscopic biopsy are useful in the differential diagnosis of a stricture of the ampulla of vater with a grossly normal appearance. Cancer patients typically present with an early stage and the prognosis is relatively good. (Korean J Gastrointest Endosc 2008;37:185-191)

2,090 View
9 Download

Photodynamic Therapy for Superficial Gastrointestinal Tumors: Young Koog Cheon, M.D., Dae Hee Han, M.D., In Seop Jung, M.D., Chang Beom Ryu, M.D., Joo Young Cho, M.D., Yun Soo Kim, M.D., Joon Seong Lee, M.D., Moon Sung Lee, M.D., Chan Sup Shim, M.D. and Boo Sung Kim, M.D.; Korean J Gastrointest Endosc 2006;32(2):81-86. Published online February 27, 2006

Abstract PDF: Background
/Aims: Although photodynamic therapy (PDT) has been used for the endoscopic treatment of digestive cancer, its curative efficacy remains uncertain. This study evaluated the curative role of PDT in superficial gastrointestinal cancer. Methods: Fifteen lesions in 14 patients with a histologically proven carcinoma (early esophageal cancer 6, early gastric cancer 8, ampulla of Vater cancer 1) were injected with an intravenous hematoporphyrin derivative (2 mg/kg), and PDT was performed 48 hours later. The response to treatment was assessed by gastroscopy with biopsies. Results: The median follow-up time was 273 days (42∼1,030 days). According to the TNM stage of endoscopic ultrasonography, there were 14 T1 cases and 1 T2 case. Complete remission was observed in 13 cases after the initial and consecutive PDT. There were 2 cases of failure. The recurrence rate was 15.4% (2/13), and the median time from the initial PDT to recurrence was 349 days. Conclusions: PDT using a hematoporphyrin derivative as a photosensitizer is a safe and efficient method for treating early cancer. However, a long-term follow up period using a large population sample will be needed for confirmation. (Korean J Gastrointest Endosc 2006;32:81⁣86)

1,961 View
4 Download

Search