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- W2089862693 abstract "A 54-year-old man presented with jaundice. Total bilirubin was 29.4 mg/dL, and serum CA 19-9 was 2900.5 U/mL (normal 0-37). An abdominal CT revealed dilatation of intra- and extrahepatic bile ducts and a relatively well-enhancing mass at the major duodenal papilla. Duodenoscopy showed a huge protruding mass having dirty-based ulcerative, necrotic orifice at the major papilla (A ). The lesion was hard on palpation with a catheter. The bile duct was dilated. EUS disclosed a heterogeneous hypoechoic mass. The patient subsequently underwent radical pancreatoduodenectomy. At operation there was a 3 × 2.5 cm deeply ulcerated yellowish gray tumor at the major papilla extending to the distal common bile duct; surface shows tumor invasion of duodenal wall (B, C ). Microscopy revealed monotonous small anaplastic cells with scant cytoplasm, arranged in sheets or nests (D: H&E, orig. mag. ×40). The tumor cells had hyperchromatic nuclei and a high nuclear to cytoplasmic ratio. Mitoses were numerous. On high magnification the nuclei were hyperchromatic with coarsely clumped chromatin and indistinct nucleoli. Immunohistochemical staining was strongly positive for neuron specific enolase. Postoperatively the patient received cisplatin, etoposide, and radiation therapy. An abdominal sonogram on 4 months after surgery revealed multiple liver metastases. He died of the disease 8 months after the operation." @default.
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- W2089862693 date "2000-05-01" @default.
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- W2089862693 title "Neuroendocrine carcinoma of the ampulla of Vater" @default.
- W2089862693 doi "https://doi.org/10.1016/s0016-5107(00)70296-3" @default.
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