Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Nov 15, 2022; 14(11): 2253-2265
Published online Nov 15, 2022. doi: 10.4251/wjgo.v14.i11.2253
A rare synchrony of adenocarcinoma of the ampulla with an ileal gastrointestinal stromal tumor: A case report
Venkata Vinod Kumar Matli, Gazi B Zibari, Gregory Wellman, Poornima Ramadas, Sudha Pandit, James Morris
Venkata Vinod Kumar Matli, Department of Internal Medicine, Christus Highland Medical Center, Shreveport, LA 71106, United States
Gazi B Zibari, Division of Hepatobiliary Surgery, Willis-Knighton Health System, Shreveport, LA 711103, United States
Gregory Wellman, Department of Gastrointestinal and Liver Pathology, Christus Highland Medical Center, Shreveport, LA 71105, United States
Poornima Ramadas, Division of Hematology and Oncology, Louisiana State University Health Sciences Center, Shreveport, LA 71103, United States
Sudha Pandit, James Morris, Division of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center, Shreveport, LA 71103, United States
Author contributions: Matli VVK obtained all the required data and drafted the article after literature review; Wellman G was a gastrointestinal and liver pathologist, reviewed the slides and revised the article; Ramadas P, medical oncologist, revised the article; Pandit S, gastroenterologist, reviewed the literature and revised the article; Zibari GB, hepatobiliary surgeon and Morris J, gastroenterologist and hepatologist, critically revised the article and approved the final version of the article.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this article and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the care checklist (2016), and the manuscript was prepared and revised according to the care checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Venkata Vinod Kumar Matli, MD, Attending Doctor, Department of Internal Medicine, Christus Highland Medical Center, 1455 E Bert Kouns Industrial Loop Christus Highland Medical Center, Shreveport, LA 71106, United States. vmatli@soundphysicians.com
Received: July 11, 2022
Peer-review started: July 11, 2022
First decision: August 19, 2022
Revised: September 15, 2022
Accepted: October 2, 2022
Article in press: October 2, 2022
Published online: November 15, 2022
Core Tip

Core Tip: This case is distinctive because the patient was diagnosed with two synchronous and extremely rare high-grade primary malignancies, i.e., an ampullary adenocarcinoma arising from a high-grade dysplastic tubulovillous adenoma of the ampulla of Vater (TVAoA) with a high-grade ileal gastrointestinal stromal tumor (GIST). Based on a literature review, this is the first report of an ampullary adenocarcinoma coexisting with an ileal GIST. AoA may occur sporadically or in a familial inheritance pattern, as in the setting of familial adenomatous polyposis syndrome (FAPS). We emphasize the need for screening and surveillance colonoscopy when one encounters an AoA in upper endoscopy to check for FAPS. TVAoA is a premalignant lesion, particularly in the setting of FAPS, and carries a high risk for metamorphism to an ampullary adenocarcinoma.