Periampullary tumours are those that arise within 2 cm of the ampulla of Vater in the duodenum
Tumours that fall under this group includes four main types of tumours 1,4
- pancreatic head / uncinate process tumours - includes pancreatic ductal adenocarcinoma involving head and uncinate process of the pancreas
- lower common bile duct tumours - includes types of cholangiocarcinoma involving the intra-pancreatic distal bile duct
- ampullary tumours - those originating from the ampulla of Vater itself
- periampullary duodenal carcinoma
Although patients with periampullary tumors have similar symptoms at presentation, they exhibit different clinical outcomes according to the origin of these tumours.
Their origins are difficult and often impossible to discern based on clinical settings and on pre-operative imaging. The presence of a bulging papilla sign may suggest towards the diagnosis.
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- 1. Sugita R, Furuta A, Ito K et-al. Periampullary tumors: high-spatial-resolution MR imaging and histopathologic findings in ampullary region specimens. Radiology. 2004;231 (3): 767-74. doi:10.1148/radiol.2313030797 - Pubmed citation
- 2. Kim S, Lee NK, Lee JW et-al. CT evaluation of the bulging papilla with endoscopic correlation. Radiographics. 27 (4): 1023-38. doi:10.1148/rg.274065047 - Pubmed citation
- 3. Kim JH, Kim MJ, Chung JJ et-al. Differential diagnosis of periampullary carcinomas at MR imaging. Radiographics. 22 (6): 1335-52. doi:10.1148/rg.226025060 - Pubmed citation
- 4. Walsh RM, Connelly M, Baker M. Imaging for the diagnosis and staging of periampullary carcinomas. Surg Endosc. 2003;17 (10): 1514-20. doi:10.1007/s00464-002-8752-7 - Pubmed citation
- 5. Pham DT, Hura SA, Willmann JK et-al. Evaluation of periampullary pathology with CT volumetric oblique coronal reformations. AJR Am J Roentgenol. 2009;193 (3): W202-8. doi:10.2214/AJR.08.2069 - Pubmed citation
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