Case Report

Surgery Today

, Volume 44, Issue 5, pp 952-956

First online:

Hepatopancreatoduodenectomy for anastomotic recurrence from residual cholangiocarcinoma: report of a case

  • Seiji NatsumeAffiliated withDivision of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine
  • , Tomoki EbataAffiliated withDivision of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine
  • , Yukihiro YokoyamaAffiliated withDivision of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine
  • , Tsuyoshi IgamiAffiliated withDivision of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine
  • , Gen SugawaraAffiliated withDivision of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine
  • , Yu TakahashiAffiliated withDivision of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine
  • , Masato NaginoAffiliated withDivision of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine Email author 

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Abstract

Resection of cholangiocarcinoma often results in a positive ductal margin, from carcinoma in situ (CIS) near the main tumor; however, the biological behavior of the residual CIS after surgical resection remains equivocal. We report a case of late local recurrence of CIS, defined as long-term tumor progression from CIS residue at the ductal stump. The patient, a 73-year-old man, had undergone bile duct resection for distal cholangiocarcinoma, leaving positive ductal margins with CIS. A biliary stricture was found 10 years later at the site of anastomosis, and right hepatectomy with pancreatoduodenectomy was performed. Based on histological analogy and the evidence of remnant CIS, a final diagnosis of late local recurrence from the CIS foci was made. This uncommon mode of recurrence should be considered in patients with early-stage disease with expected favorable survival because salvage surgery is feasible for selected patients.

Keywords

Anastomotic recurrence Cholangiocarcinoma Carcinoma in situ