Roberto Bruno
Universidade do Estado do Rio Janeiro, Brazil
Scientific Tracks Abstracts: Surgery Curr Res
This work aims to report a rare case of metastatic adenocarcinoma presentation of Ampulla of Vater to the right scapula, as first manifestation of systemic metastatic disease. A 45 year-old male patient was diagnosed with adenocarcinoma of the ampullary region, infiltrating the duodenal wall, pancreas and peri-pancreatic tissue. The patient underwent Whipple surgery (pancreatico duodenectomy) for tumor resection. The histopathological study has revealed poorly differentiated adenocarcinoma with extensive peri-neural infiltration, vascular invasion with embolization of tumor cells and regional lymph nodes without neoplastic involvement. Four months after surgery for resection of ampullary tumor, the patient had severe pain in the right shoulder, which subsequently evolved with the emergence of a suprascapular lump on the same side. It underwent incisional biopsy that revealed adenocarcinoma on the histo-pathological study. It was chosen for tumor resection surgery. During surgery, a link between tumor and bone tissue of the right scapula was observed, leading to the decision to remove the bone fragment to study. The histo-pathological study defined the presence of metastatic adenocarcinoma focally for bone tissue, infiltrating skin, subcutaneous tissue and adjacent muscle. Subsequently, a bone scintigraphy which revealed a heterogeneous hyper-fixation of the contrast media in the topography of the right scapula (medial edge) was performed. Unfortunately, after these events, the patient developed metastatic systemic dissemination, which led to his death. We conclude that this is a presentation of rare and unusual metastatic disease. In our research, it wasn't found any cases of scapula metastasis from Ampulla of Vater adenocarcinoma.
Email: robert0brun0@hotmail.com
