Clinicopathological Findings of Adenocarcinoma of Ampulla of Vater: A Single Center Experience

Abstract

Background:

Adenocarcinoma of the ampulla of Vater is a rare gastrointestinal cancer characterized by unique clinical and histopathological aspects. The annual incidence of ampullary adenocarcinoma has been increasing, and unlike pancreatic cancer, ampullary adenocarcinoma is often curable when diagnosed early. This study aimed to determine the clinicopathological features of ampullary adenocarcinomas based on a single-center experience.

Materials and Methods:

We conducted a retrospective study of patients diagnosed with ampullary lesions at our center from April 2020 to November 2024. A single pathologist reviewed all pathological reports and histopathological findings. Data on patient demographics, clinical presentations, histopathological subtypes, and tumor staging were systematically collected and analyzed.

Results:

A total of 47 patients were included, regarding tumor histology types, 43 patients had a pathological diagnosis of adenocarcinoma with a mean age of 55.81 years and a male-to-female ratio of 1.69 (P= 0.615). Obstructive jaundice was the most common presenting symptom, observed in 76.7% of cases with adenocarcinoma. Histopathological examination revealed 21(48.8%) intestinal and 22 (51.2%) pancreatobiliary subtypes. Survival and cure rates were higher in the intestinal type than in the pancreatobiliary type. Most adenocarcinomas (67.4%) were well differentiated and had better outcomes than those with moderately or poorly differentiated grades. Also, the cure rate was higher for negative lymph node involvement and limited tumor extension. Positive margins, advanced-stage tumors, and invasive characteristics correlated with poorer survival.

Conclusion: 

We have found that adenocarcinomas are the most common type of tumors of the ampulla of Vater, followed by adenomatous polyps, gastrointestinal stromal tumor (GIST), and neuroendocrine tumor (NET) in the south of Iran from 2020 to 2024. Our findings emphasize the need for further research to deepen understanding of ampullary tumors and guide treatment and predict outcomes.