Ampullary carcinoma is a rare malignant tumor originating at the ampulla of Vater, in the last centimeter of the common bile duct, where it passes through the wall of the duodenum and ampullary papilla. Patients typically present with symptoms related to biliary obstruction. Sometimes during an upper endoscopy, adenoma polyps are found and biopsied. These polyps are usually removed as they are considered precancerous and if left untreated, cancer may develop or they may cause blockage of the bile/pancreatic ducts.