Fact-sheet: Ampullary tumor - vater
  • Adenocarcinoma of the ampulla of Vater


Updated on 03/26/2020 at 2:09 PM

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Definition

Malignant glandular epithelial tumor arising from the cells of the ampulla of Vater.

Clinical features

- Intermittent jaundice
- Deterioration of general condition
- Transfixing abdominal pain

Ultrasound

Dilatation of the common bile duct, intrahepatic bile ducts, and pancreatic duct of Wirsung.

CT

Lobulated soft tissue lesion centered on the ampulla of Vater.
Double-duct sign with dilatation of the common bile duct and Wirsung duct.
After injection: moderate hypodense enhancement relative to the adjacent pancreas

MRI

MR cholangiopancreatography: Shows dilatation of the bile ducts and pancreatic duct upstream of the obstruction.
T1: Lesion isointense to the pancreas.
T2: Intermediate signal.
T1 post-gadolinium: relative hyposignal compared with the adjacent pancreas

Management

Surgical management by pancreaticoduodenectomy

Differential diagnosis

Ampullary adenoma
Pancreatic adenocarcinoma