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Alpha-fetoprotein producing carcinoma of the gallbladder associated with anomalous arrangement of the pancreaticobiliary ductal system—Early detection through an attack of acute pancreatitis

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Summary

A 56-year-old female was admitted to our hospital with a diagnosis of acute pancreatitis. Ultrasonography revealed a hypoechoic tumor in the gallbladder. The serum α-fetoprotein (AFP) level was 971 ng/ml. After healing of the acute pancreatitis, the anomalous arrangement of the pancreaticobiliary ductal system (APDS) was demonstrated by ERCP with mild dilatation of the common bile duct. Within one month after admininon, AFP level reached 4390 ng/ml. On operation, a pedunculated tumor, 6.5 × 3 cm in size, was found in the gallbladder. Histological examination revealed a moderately differentiated adenocarcinoma and positive immunohistochemical staining of cancer cells for AFP. After absolutely curative (stage II) resection, normal serum AFP levels were recognized. This is the first report of an AFP-producing cancer of the gallbladder associated with APDS and it was detected as a result of an attack of acute pancreatitis.

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References

  1. Babbitt DP. Congenital choledochal cyst: New etiological concept based on anomalous relationships of the common bile duct and pancreatic duct. Ann Radiol 1969;12:231–240.

    PubMed  CAS  Google Scholar 

  2. Komi N, Udaka H, Ikeda N, et al. Congenital dilatation of the biliary tract; New classification and study with particular reference to anomalous arrangement of the pancreaticobiliary ducts. Gastroenterologia Japonica 1977;12:293–305.

    PubMed  CAS  Google Scholar 

  3. Kimura K, Ohto M, Saisho H, et al. Association of gallbladder carcinoma and anomalous pancreaticobiliary ductal union. Gastroenterol 1985;89:1258–1265.

    CAS  Google Scholar 

  4. Tatarinov JS. Detection of embryo-specifi α-globulin in the blood sera of patient with primary liver tumor. Vopr Med Khim 1964;10:90–91.

    PubMed  CAS  Google Scholar 

  5. Kato K, Akai S, Tobita Y, et al. α-fetoprotein -positive cases in cancer except for hepatoma and malignant teratoma. Mainly on the sum up data in Japan. Jpn J Cancer Clin 1974;20:376–382. (in Japanese)

    Google Scholar 

  6. Tsung SH. Alpha-fetoprotein in lung cancer metastatic to the liver. Arch Pathol 1975;99:267–269

    PubMed  CAS  Google Scholar 

  7. Macintire KR, Waldmann TA, Moertel CG, et al. Serum α-fetoprotein in patients with neoplasms of the gastrointestinal tract. Cancer Res 1975;35:991–996.

    Google Scholar 

  8. Todani T. A proposal of diagnostic criteria for anomalous arrangement of the pancreaticobiliary ductal union. Biliary Tract & Pancreas 1987;8:115–118. (in Japanese)

    Google Scholar 

  9. Miyano T, Suruga K, Yamashiro Y, et al. Anomalous choledochopancreatic ductal junction syndrome-Particularly concerning pancreatic lesions. Biliary Tract & Pancreas 1985;6:1627–1637. (in Japanese)

    Google Scholar 

  10. Asano H, Kobari M, Takeda K, et al. A case of early gallbladder cancer with acute pancreatitis caused by anomalous arrangement of pancreaticobiliary duct. Biliary Tract & Pancreas 1990;11:437–442. (in Japanese)

    Google Scholar 

  11. Aoki H, Sugaya H, Shimazu M, et al. Anomalous arrangement of the pancreaticobiliary ductal union and biliary carcinoma. Biliary Tract & Pancreas 1987;8:1539–1551.

    Google Scholar 

  12. Seguchi M, Kumazawa K, Ohtani Y, et al. A case of gallbladder cancer with abnormal confluence of the pancreatic and bile ducts not accompanied by cholangiectasis. J Tokyo Women’s College of Medicine 1991;61:85–89. (in Japanese)

    Google Scholar 

  13. Uchimura M, Waki S, Kida H, et al. Anomalous arrangement of pancreaticobiliary ductal system and biliary carcinoma. Biliary Tract & Pancreas 1991;12:397–404. (in Japanese)

    Google Scholar 

  14. Noguchi A. Cell kinetic studies on mucosa of the gallbladder by using anti bromodeoxyuridine monoclonal antibody in patients with anomalous arrangement of the pancreaticobiliary ductal system. J Japanese Gastroenterol Surg 1988;21:210–220. (in Japanese)

    Google Scholar 

  15. Matsumoto Y, Mogaki M, Miura K, et al. Clinicopathological study on carcinoma of the gallbladder-with special references of 24 patients with anomalous arrangement of the pancreaticobiliary ductal system, Yamanashi Med J 1989;4:73–81.

    Google Scholar 

  16. Abelev GI, Perova SD, Khramkova NI, et al. Production of embryonic α-globulin transplantable mouse hepatomas. Transplantation 1963;l:174–180.

    Article  Google Scholar 

  17. Kishimoto Y, Horie Y, Suou T, et al. A case of gallbladder carcinoma producing both α-fetoprotein (AFP) and carcino-embryonic antigen (CEA) with large metastatic lesions in liver and bone. Acta Hepat Jap 1991;32:78–84. (in Japanese)

    Google Scholar 

  18. Aoyagi Y, Usui M, Kashii A, et al. Four cases of serum α-fetoprotein positive cancers (three gastric cancers and one gallbladder cancer) Jpn J Gastroenterol Surg 1985;18:518. (in Japanese)

    Google Scholar 

  19. Nakano M, Nakatani A, Sameshima Y, et al. Gall bladder carcinoma producing AFP and CEA-A case report-Byouri To Rinsho 1986;4:1101–1105. (in Japanese)

    Google Scholar 

  20. Katsuragi M, Enomoto Y, Toyoda T, et al. A case of gall bladder cancer with high level alpha-fetoprotein. Jpn J Clin Radiol 1989;34:371–374. (in Japanese)

    CAS  Google Scholar 

  21. Seki M, Hori M, Takagi K, et al. Radically resected AFP-positive cancer of the gallbladder: Report of a case. Shoukakigeka 1990;13:1977–1984. (in Japanese)

    Google Scholar 

  22. Imazu H, Kasahara M, Shirono K, et al. A case of gallbladder carcinoma with high serum level of α-fetoprotein. Biliary Tract & Pancreas 1991;12:1053–1057. (in Japanese)

    Google Scholar 

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Ikeda, M., Okada, S., Morozumi, A. et al. Alpha-fetoprotein producing carcinoma of the gallbladder associated with anomalous arrangement of the pancreaticobiliary ductal system—Early detection through an attack of acute pancreatitis. Gastroenterol Jpn 27, 668–674 (1992). https://doi.org/10.1007/BF02774984

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  • DOI: https://doi.org/10.1007/BF02774984

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