The specimen shows the distal portion of the stomach and the proximal part of the duodenum; there
is a sessile, coarsely-nodular tumour some 4.0 cm. across arising in the second part of the duodenum
in relation to the ampulla. The common bile duct is thickened and dilated.
The patient had intermittent jaundice for several months; the tumour was seen on
endoscopy. The tumour is a papillary adenocarcinoma; there were microscopic foci of metastatic
tumour in the adjacent fatty tissue.