Endoscopic resection of an ampullary carcinoid presenting with upper gastrointestinal bleeding: a case report and review of the literature

Abstract

Ampullary carcinoid is a rare tumor that can present with gastrointestinal bleeding, obstructive jaundice or pancreatitis. Some of these tumors are associated with Von Recklinghausen disease. The usual surgical options are a biliary-enteric anastomosis, Whipple procedure or rarely a local resection. The mean survival does not appear to be much different after a pancreaticoduodenectomy versus local surgical excision. We report a very rare case of a non-metastatic ampullary carcinoid causing upper gastrointestinal bleeding, which was managed by endoscopic ampullectomy.

Figure 1

Endoscopic view showing an ampullary tumor (A) and the same area weeks after endoscopic resection of the tumor (B).

Figure 2

Histological examination of the resected specimen revealing carcinoid in the mucosa and submucosa, composed of discrete solid nests of round tumor cells with central nuclei and occasionally with gland-like lumina (A) and solid nests of tumor cells involving the musclaris propria (B) (HE, x 100).