Ampullary carcinomas should be differentiated from the carcinomas arising in the head of pancreas, carcinomas arising in the terminal third of the common bile duct (cholangiocarcinoma), and duodenal adenocarcinomas. There are major clinical and prognostic implications. Ampullary carcinomas have a much better prognosis than pancreatic adenocarcinomas as well as cholangiocarcinomas. The overall 5-yr survival rate is 50-80% and directly depends upon the stage of disease. Image courtesy of: Dr. Terri Crook, Dallas, Texas.