Ampulloma excised - Forum

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bonjorno

Ampulloma excised - Ärzteforum

Post#1 »

As it was decided in Clinical Meeting,the decission about how to approach the lately presented Ampulloma, was to perform a wide local excission through endoscopic approach.

I want to tell you that the 10 biopsies taken from the surface of the tumor,were informed as Adenoma...When the excission took place, it was possible to surround the tumor,measuring 2x3 cms approx., completely with the electrode wire.

Once the tumor was cut,no bleeding took place and bile started to flow

Yet,we had the feeling that the "Adenoma" continued to grow in some small extent, inside the CBD...This, we thought, was a bad sign regarding the nature of the tumor and the whole of it was sent to Path...If there's any sign of malignancy,we'll proceed to perform a Whipple's operation and I personally think that this is the most probable thing that will happen...I'm well aware that 65% of ampullomas measuring more than 2 cms. in diameter are malignant.

P.S. I attach a pic of the excised ampulloma.


bonjorno

Re: Ampulloma excised - Ärzteforum

Post#2 »

Pic

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pic.jpg (15.36 KiB) Viewed 139 times

bonjorno

Re: Ampulloma excised - Ärzteforum

Post#3 »

I received this morning the path's report which I translate literally :

Macroscopic Examination : Nodular structure of villous aspect measuring 2 x 1,5 x 3 cms, of red brownish colour.

Hystological Examination : The sample to be examined corresponds to duodenal mucosa with development of epithelial neoformation constituted by tubular and papillar structures with connective estroma covered by cylindrical, mature, pseudostratified epithelium with no athipies in a estroma with haemorrhage and mixed inflammatory infiltrate.Surgical border section free of neoplasia with signs of electrocoagulation.

Conclusion: Villous Adenoma Totally Excised.

The patient has done well, jaundice went back almost completely,no signs of cholangitis...

Any suggestions?...

What should be done next?

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