Our technique of cannulating both ducts differs from previously reported methods of local excision, providing a more accurate and safer resection of the tumor. Histologically, the excised ampullary mass was found to be a carcinoid tumor. The removed gallbladder revealed cholelithiasis and chronic cholecystitis. The patient made an uneventfully recovery and was discharged after 10 days. Endoscopic image of carcinoid tumor of the amulla of vater.
Immunohistochemical stain shows positive reaction for chromogranin in the tumor nests.
Discussion Carcinoid tumors are potentially malignant. The distinction between a benign and malignant carcinoid usually is made best by assessing the size of the tumor and the presence or absence of metastases, rather than by its histological features1-3. Most patients with duodenal carcinoids are asymptomatic or have nonspecific symptoms. Larger tumors in the ampullary region may cause symptoms of obstruction. Jaundice is the most common presentation, occurring in approximately two-thirds of patients5,6.