Surgery Today

, Volume 44, Issue 5, pp 952–956 | Cite as

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

  • Seiji Natsume
  • Tomoki Ebata
  • Yukihiro Yokoyama
  • Tsuyoshi Igami
  • Gen Sugawara
  • Yu Takahashi
  • Masato Nagino
Case Report

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 

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Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Seiji Natsume
    • 1
  • Tomoki Ebata
    • 1
  • Yukihiro Yokoyama
    • 1
  • Tsuyoshi Igami
    • 1
  • Gen Sugawara
    • 1
  • Yu Takahashi
    • 1
  • Masato Nagino
    • 1
  1. 1.Division of Surgical Oncology, Department of SurgeryNagoya University Graduate School of MedicineNagoyaJapan

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