{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:43:53Z","timestamp":1753886633355,"version":"3.41.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,6,8]],"date-time":"2020-06-08T00:00:00Z","timestamp":1591574400000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Neuroendocrine tumor (NET) of the ampulla of Vater is a rare presentation of biliary obstruction. Here, we present a case of NET and discuss the current recommendations that necessitate different management and surgical treatment than other sites. A 56-year-old Caucasian female presented with 2\u00a0years of right upper quadrant pain. Workup revealed a well-differentiated 2.2\u00a0cm NET at the ampulla with 0 MF\/10 HPF, Stage 1A T2NOMO. Whipple procedure performed with 2.2\u00a0cm ampullary NET with 1 of the 15 lymph node metastases and &amp;lt;2 mitoses in 10 HPF. TNM classification: Stage IV T2N1MO. Regardless of tumor size, NETs metastasize in half of cases. Local excisions including endoscopic and laparoscopic ampullectomy were recommended only for poor surgical candidates. Ampullary NETs behave more aggressively than nonampullary NETs and their biological behaviors are irrespective of size. For patients of acceptable surgical risk, we recommend radical resection utilizing Whipple procedure.<\/jats:p>","DOI":"10.1093\/jscr\/rjaa119","type":"journal-article","created":{"date-parts":[[2020,4,10]],"date-time":"2020-04-10T11:07:53Z","timestamp":1586516873000},"source":"Crossref","is-referenced-by-count":10,"title":["Neuroendocrine carcinoma of the ampulla of Vater: a case report, review and recommendations"],"prefix":"10.1093","volume":"2020","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7104-1710","authenticated-orcid":false,"given":"Thomas K","family":"Kleinschmidt","sequence":"first","affiliation":[{"name":"Department of Medical Education, Brookwood Baptist Health Systems, Birmingham, AL, USA"},{"name":"Department of Hepatobiliary and Pancreatic Surgery, Grandview Medical Center, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Christein","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Grandview Medical Center, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,6,5]]},"reference":[{"key":"2020060802042795900_ref1","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.3748\/wjg.v16.i12.1527","article-title":"Surgically treated primary malignant tumor of small bowel: a clinical analysis","volume":"16","author":"Han","year":"2010","journal-title":"World J Gastroenterol"},{"key":"2020060802042795900_ref2","doi-asserted-by":"crossref","first-page":"90","DOI":"10.4103\/0019-509X.35816","article-title":"Carcinoid of ampulla of Vater","volume":"44","author":"Rohan","year":"2007","journal-title":"Indian J Cancer"},{"key":"2020060802042795900_ref3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1590\/S0004-28032013000100002","article-title":"Carcinoid tumor of the duodenum: a rare tumor at an unusual site. Case series from a single institution","volume":"50","author":"Waisberg","year":"2013","journal-title":"Arq Gastroenterol"},{"key":"2020060802042795900_ref4","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1007\/s11605-013-2365-4","article-title":"Clinical outcomes for neuroendocrine tumors of the duodenum and ampulla of Vater: a population-based study","volume":"18","author":"Randle","year":"2014","journal-title":"J Gastrointest Surg"},{"key":"2020060802042795900_ref5","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.5858\/2009-0697-OAR.1","article-title":"Carcinoids and high-grade neuroendocrine carcinomas of the ampulla of Vater: a comparative analysis of 139 cases from the surveillance, epidemiology, and end results program\u2014a population based study","volume":"134","author":"Albores-Saavedra","year":"2010","journal-title":"Arch Pathol Lab Med"},{"key":"2020060802042795900_ref6","first-page":"52","article-title":"Pathologic observations of the duodenum in 615 consecutive duodenal specimens in a single Japanese hospital: II. Malignant lesions","volume":"5","author":"Terada","year":"2012","journal-title":"Int J Clin Exp Pathol"},{"key":"2020060802042795900_ref7","first-page":"263","article-title":"Neuroendocrine tumors of the ampulla of Vater: presentation, pathology and prognosis","volume":"13","author":"Jayant","year":"2012","journal-title":"JOP"},{"key":"2020060802042795900_ref8","first-page":"422","article-title":"Neuroendocrine carcinoma of the ampulla of Vater: a clinicopathologic evaluation","volume":"7","author":"Selvakumar","year":"2008","journal-title":"Hepatobiliary Pancreat Dis Int"},{"key":"2020060802042795900_ref9","doi-asserted-by":"crossref","first-page":"e5","DOI":"10.1016\/j.cgh.2009.07.021","article-title":"Ampullary carcinoid: diagnostic challenges and update on management","volume":"8","author":"Krishna","year":"2010","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2020060802042795900_ref10","doi-asserted-by":"crossref","first-page":"3063","DOI":"10.1200\/JCO.2007.15.4377","article-title":"One hundred years after \"carcinoid\": epidemiology of and prognostic factors for neuroendocrine tumors in 35, 825 cases in the United States","volume":"26","author":"Yao","year":"2008","journal-title":"J Clin Oncol"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jscr\/article-pdf\/2020\/6\/rjaa119\/33346766\/rjaa119.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jscr\/article-pdf\/2020\/6\/rjaa119\/33346766\/rjaa119.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T05:16:05Z","timestamp":1615180565000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjaa119\/5851592"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,1]]},"references-count":10,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjaa119","relation":{},"ISSN":["2042-8812"],"issn-type":[{"type":"electronic","value":"2042-8812"}],"subject":[],"published-other":{"date-parts":[[2020,6]]},"published":{"date-parts":[[2020,6,1]]},"article-number":"rjaa119"}}