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International Cancer Conference Journal

, Volume 8, Issue 1, pp 7–11 | Cite as

Intrahepatic bile duct adenoma in a patient with gastric cancer

  • Tsutomu NamikawaEmail author
  • Sachi Tsuda
  • Kazune Fujisawa
  • Eri Munekage
  • Jun Iwabu
  • Masaya Munekage
  • Sunao Uemura
  • Shigehiro Tsujii
  • Hiromichi Maeda
  • Hiroyuki Kitagawa
  • Mitsuko Iguchi
  • Ichiro Murakami
  • Michiya Kobayashi
  • Kazuhiro Hanazaki
Case report
  • 17 Downloads

Abstract

We report a case of intrahepatic bile duct adenoma (BDA) detected during laparoscopic distal gastrectomy for gastric cancer. A 70-year-old man was referred to our hospital for the treatment of gastric cancer. Esophagogastroduodenoscopy revealed an irregular, nodular, and elevated lesion on the greater curvature side of the middle third of the stomach. Abdominal contrast-enhanced computed tomography showed wall thickening with homogeneous enhancement in the middle part of the stomach, and no lesions in the liver. The patient underwent laparoscopic distal gastrectomy with regional lymphadenectomy, and during the operation a small whitish nodule was observed on the lateral segment of the liver surface. The lesion was excised by partial resection of the liver for the purpose of both histological diagnosis and treatment. Pathological examination of the liver lesion revealed no structural or cellular atypia, no stromal invasion, and immunohistochemical positivity for CK7 and CK19, but negativity for p53. The final diagnosis was well-differentiated adenocarcinoma invading the gastric serosal layer without lymph node metastasis, and intrahepatic BDA measuring 0.4 × 0.3 cm. Following surgery, the patient remained symptom-free without evidence of recurrence for 5 months. To the best of our knowledge, this is the first case of BDA with gastric cancer. Because it is difficult to distinguish BDA from other liver tumors including metastatic cancer due to its characteristically small size and lack of specific morphological features on standard imaging, surgical resection should be considered as the most suitable approach for both accurate diagnosis and treatment.

Keywords

Bile duct adenoma Gastric cancer Intrahepatic bile duct Benign tumor 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Research involving human and/or animal rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Copyright information

© The Japan Society of Clinical Oncology 2018

Authors and Affiliations

  • Tsutomu Namikawa
    • 1
    Email author
  • Sachi Tsuda
    • 1
  • Kazune Fujisawa
    • 1
  • Eri Munekage
    • 1
  • Jun Iwabu
    • 1
  • Masaya Munekage
    • 1
  • Sunao Uemura
    • 1
  • Shigehiro Tsujii
    • 1
  • Hiromichi Maeda
    • 2
  • Hiroyuki Kitagawa
    • 1
  • Mitsuko Iguchi
    • 3
  • Ichiro Murakami
    • 3
  • Michiya Kobayashi
    • 2
    • 4
  • Kazuhiro Hanazaki
    • 1
  1. 1.Department of SurgeryKochi Medical SchoolKochiJapan
  2. 2.Cancer Treatment CenterKochi Medical School HospitalKochiJapan
  3. 3.Department of PathologyKochi Medical SchoolKochiJapan
  4. 4.Department of Human Health and Medical SciencesKochi Medical SchoolKochiJapan

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