Gastrointestinal stromal tumor of the duodenal ampulla: report of a case.

We report herein the case of a 77-year-old woman with a gastrointestinal stromal tumor (GIST) of the duodenal ampulla. The tumor, which was removed by pancreatoduodenectomy due to its malignant potential, showed expansive growth in the muscular coat of the duodenal ampulla. Histologically, the tumor cells were spindle-shaped or round, and exhibited fascicular or storiform growth pattern with frequent mitotic figures. The immunohistochemical and ultrastructural results suggested that the tumor may have originated from the interstitial cells of Cajal in the muscular coat of the duodenal ampulla. To our knowledge, this is the first case of malignant GIST of the duodenal ampulla to be reported in Japan.