Carcinoid tumours of duodenum and ampulla of Vater

Clinical features

Ampullary carcinoids commonly (>60%) cause jaundice.

Immunohistochemistry

	duodenal carcinoid	ampullary Carcinoid
chromogranin	6/81, 97%*	1/51, 92%*
synaptophysin	2/81	1/51, 100%*
Leu7	91%*
NSE	7/81, 83%*	4/51, 100%*
S-100	1/81	0/51
gastrin	6/81, 68%*	1/51

*: based on a review of the literature1.

Prognosis

Duodenal carcinoids appear to be indolent with a 5-year death rate of 5.3%. Spread into the muscularis propria, size >2 cm and mitotic activity are risk factors for metastasis. Ampullary carcinoids are more aggressive, with a death rate of 33% at 4.2 years.

References

1Bornstein-Quevedo, L., Gamboa-Dominguez, A. Carcinoid tumors of the duodenum and ampulla of vater: a clinicomorphologic, immunohistochemical, and cell kinetic comparison. Human Pathol 2001;32:1252-1256

This page last revised 6.5.2002.