Histopathological study of pancreatobiliary tumors in a tertiary care center: a 7 year study

Authors

  • Manan Shah Department of Radiation Oncology, Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India
  • Saba Shafi Department of Pathology, Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India
  • Junaid Shafi Department of Critical Care Medicine, ISIC, India
  • Momin Shah MBBS Student, ASCOMS, Jammu, India
  • Parveen Shah Department of Pathology, Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India
  • Omar J. Shah Department of Surgical Gastroenterology, Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20181466

Keywords:

Ampulla, Pancreatobiliary tumors

Abstract

Background: The aim of this study was to comprehensively analyse the histopathological spectrum of pancreatobiliary tumors with special reference to ampulla of Vater.

Methods: The retrospective study was done for 5 years and a prospective study was carried out for 2 years in the Department of Pathology.

Results: A total of 110 cases were included; 103 underwent a standard Whipple procedure and 7 underwent localised resection (partial pancreatectomy). The average age was 52.64 years (16-80 years) and males outnumbered females (3:2). Malignant (93.63%) lesions outweighed benign lesions (6.36%). Among malignant lesions, 71 (68.93%) were peri-ampullary, 15 (14.56%) were pancreatic, 11 (10.67%) were duodenal and only 6 (5.825%) were cholangiocarcinoma. The most common presenting feature was jaundice followed by pain in the abdomen. The mean tumor size was 2.38 cm (0.5-15cm). The pathological stage of most of the tumors was T2 (58.2%), followed by T3 (22.7%), T1 (11.8%) and T4 was only 1.8%. Proximal duodenal resection margin was free in 90.9%, distal duodenal resection margin was free in all cases, CBD resection margin was involved in only 2 cases (1.8%), while the pancreatic duct resection margin was involved in 2.7%. The nodal status was N0 in 61.8%, N1 in 23.6% and Nx in 9.1%.

Conclusions: Adenocarcinoma (well differentiated-47.3%) is the most common histological variant of pancreatobiliary region.

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References

Romiti A, Barucca V, Zullo A, Sarcina I, Di Rocco R, D’Antonio C, et al. Tumors of ampulla of Vater: a case series and review of chemotherapy options. World journal of gastrointestinal oncology. 2012 Mar 15;4(3):60.

Foldes J. Early carcinoma of the ampulla of Vater. Am J Cancer. 1939;36:574-7.

Kayahara M, Nagakawa T, Ohta T, Kitagawa H, Ueno K, Tajima H, et al. Analysis of paraaortic lymph node involvement in pancreatic carcinoma. Cancer. 1999 Feb 1;85(3):583-90.

Klempnauer J, Ridder GJ, Maschek H, Pichlmayr R. Carcinoma of the ampulla of Vater: determinants of long-term survival in 94 resected patients. HPB Surgery. 1998;11(1):1-1.

Benhamiche AM, Jouve JL, Manfredi S, Prost P, Isambert N, Faivre J. Cancer of the ampulla of Vater: results of a 20-year population-based study. European journal of gastroenterology & hepatology. 2000 Jan;12(1):75-9.

Takashima M, Ueki T, Nagai E, Yao T, Yamaguchi K, Tanaka M, et al. Carcinoma of the ampulla of Vater associated with or without adenoma: a clinicopathologic analysis of 198 cases with reference to p53 and Ki-67 immunohistochemical expressions. Modern Pathology. 2000 Dec;13(12):1300.

Yamaguchi K, Enjoji M. Carcinoma of the ampulla of Vater. A clinicopathologic study and pathologic staging of 109 cases of carcinoma and 5 cases of adenoma. Cancer. 1987 Feb 1;59(3):506-15.

Foroughi F, Mohsenifar Z, Ahmadvand A, Zare K. Pathologic findings of Whipple pancreaticoduodenectomy: a 5-year review on 51 cases at Taleghani general hospital. Gastroenterology and Hepatology from bed to bench. 2012;5(4):179.

Yeo CJ, Sohn TA, Cameron JL, Hruban RH, Lillemoe KD, Pitt HA. Periampullary adenocarcinoma: analysis of 5-year survivors. Annals of surgery. 1998 Jun;227(6):821.

Riall TS. Population-based outcomes in pancreatic cancer: Improvements in survival, underutilization of surgical resection for early stage disease, and regionalization of care (Doctoral dissertation); 2007.

Van Roest MH. Results of pancreaticoduodenectomy in patients with peri-ampullary adenocarcinoma; perineural growth more important prognostic factor than tumor localisation. Ann Surg. 2008;248:97-103.

Yeo CJ, Cameron JL, Sohn TA, Lillemoe KD, Pitt HA, Talamini MA, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Annals of surgery. 1997 Sep;226(3):248.

Jemal A et al. Cancer statistics. CA Cancer J.Clin, 2007;57:43-56.

Dr Willouw de K. A Study of Morphological, Immunohistochemical And Histochemical Features of Ampullary Carcinomas. Faculty of Health Sciences. University of Cape Town; 2005.

Liu SH, Tsay SH. Coexistence of large cell neuroendocrine carcinoma and adenocarcinoma of the ampulla of vater. Journal of the Chinese Medical Association. 2008 Oct 1;71(10):536-40.

Hatzitheoklitos E, Büchler MW, Friess H, Poch B, Ebert M, Mohr W, et al. Carcinoid of the ampulla of Vater. Clinical characteristics and morphologic features. Cancer. 1994 Mar 15;73(6):1580-8.

Brauner E, Kuten J, Ben-Ishay O, Hershkovitz D, Kluger Y. Gastrointestinal stromal tumor of the ampulla of Vater. The Israel Medical Association journal: IMAJ. 2012 Sep;14(9):588.

Santini D, Poli F, Lega S. Solid-papillary tumors of the pancreas: histopathology. Jop. 2006 Jan 11;7(1):131-6.

Adsay NV. Cystic lesions of the pancreas. Modern Pathology. 2007 Feb 1;20(1s):S71.

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Published

2018-04-25

How to Cite

Shah, M., Shafi, S., Shafi, J., Shah, M., Shah, P., & Shah, O. J. (2018). Histopathological study of pancreatobiliary tumors in a tertiary care center: a 7 year study. International Journal of Research in Medical Sciences, 6(5), 1534–1537. https://doi.org/10.18203/2320-6012.ijrms20181466

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Original Research Articles