Ampulla of Vater
Premalignant / noninvasive
Intra-ampullary papillary-tubular neoplasm (IAPN)

Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 22 January 2016, last major update December 2012

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PubMed Search: IAPN
Definition / General
  • First described in 2010 (Am J Surg Pathol 2010;34:1731)
  • Highly analogous to pancreatic or biliary intraductal tubulopapillary neoplasm, with variable cell lineage, and spectrum of dysplastic change (adenoma-carcinoma sequence)
  • Biologically indolent
  • Noninvasive examples have excellent prognosis, invasive tumors have better prognosis than other ampullary malignancies
  • 28% of ampillary carcinomas arise in association with IAPNs
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