Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
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Case Report

Volume 11, Number 3, June 2018, pages 231-234

Renal Cell Carcinoma Presenting as an Ampullary Mass: A Case Report and Review of Literature


Figure 1.
Figure 1. (a) FNA cytology of ampullary mass (in higher magnification, × 400) showing tumor cells with marked nuclear pleomorphism, prominent nucleoli, and overt vacuolization to the cytoplasm. (b) Immunohistochemistry showing diffuse nuclear immunoreactivity for PAX 8.


Table 1. Review of Literature [5-8, 17-21]
PatientAgeGenderDiagnosis prior to ampullary metastasis?Side of tumorStaging of RCC at diagnosisTime from nephrectomy to ampullary diagnosisSymptomsOutcome
1 [8]50MNRN/AN/AJaundice, fever, malaise, fatigue, GI bleed/anemia, weight lossPancreatoduodenectomy (curative 5 years)
2 [17]77MY (w/ nephrectomy)RStage 43 yearsJaundiceSunitinib, endoscopic excision with APC for palliation. Died of met dz 1.5 years
3 [18]78FY (w/ nephrectomy)LStage 210 yearsPruritus, melena, weight lossPancreatoduodenectomy (curative 2.5 years)
4 [18]53MY (w/ nephrectomy)RStage 38 yearsMelena, weight lossMegace, transduodenal resection with pancreatoduodenecomy, segmental jejunum resection, and retroperitoneal lymph node dissection for mets (curative 6.5 years)
5 [19]64MY (w/ nephrectomy)LN/A11 yearsMalaise, SOB, fatigueMegace, surgical resection. Died of PE postoperatively.
6 [20]70MY (w/ nephrectomy)LStage 312 yearsWeakness, melenaWhipple (curative)
7 [7]52MY (w/ nephrectomy)R and LStage 1b10 and 4 yearsWeight loss, iron def anemia, malabsorption, steatorrheaCholedochoduodenectomy
8 [21]78FY (w/ nephrectomy)RN/A16 yearsAnemia, weight loss, melena, upper GI bleedPancreaticoduodenectomy
9 [21]68FY (w/ nephrectomy)LN/A6.5 yearsUpper GI bleeding, epigastric painClassic pancreatodudenectomy
10 [6]75MY (w/ nephrectomy)LN/A17.5 yearsUGI bleedUnknown
11 [5]55FY (w/ nephrectomy)LStage 12 yearsObstructive jaundiceDied of metastatic renal cell carcinoma
12 (our case)60FY (w/ nephrectomy)RStage 42 yearsFatigue, jaundice, nausea/vomiting