[A case of non-jaundice ampullary carcinoma with prominent lymphatic infiltration]

A case of a non-jaundiced ampullary carcinoma with a unique tumor spread is reported. A 3.2 X 1.0 cm-sized tumor at the ampulla of Vater was resected in a 64-year-old female. The primary focus of the well differentiated adenocarcinoma was confined to the intraampullary common channel, but the most of the tumor consisted of lymphatic permeation. A wide spread lymphogenous metastases had been noticed at operation, and the patient died nine months thereafter from metastases of the brain. The mechanism which prevented jaundice from developing in this case might be due to the unique way in which this tumor spread, without obstruction via the lymphatic space and only stenosing the bile duct.