Abstract
A 50-year-old Japanese woman complained of abdominal and back pain. Ten years previously she had undergone cholecystectomy, choledochectomy, and Roux-en-Y choledochojejunostomy for gallbladder cancer associated with pancreaticobiliary maljunction without bile duct dilatation. On the present admission, ultrasonography (US) and computed tomography (CT) demonstrated a large mass, 60 mm in size, in the pancreatic tail. Endoscopic retrograde cholangiopancreatography (ERCP) showed obstruction of the main pancreatic duct in the tail of the pancreas and revealed that the pancreatic duct was joined to the bile duct 25 mm above the papilla of Vater. The patient underwent distal pancreatectomy, splenectomy, left adrenalectomy, and partial gastrectomy. Histological examination revealed moderately differentiated ductal adenocarcinoma that had invaded to the proper muscle of the stomach. Double cancer of the gallbladder and pancreas in a patient with pancreaticobiliary maljunction is rare. Although the etiology of cancer of the pancreas associated with pancreaticobiliary maljunction is unclear, we should pay close attention to the pancreas as well as the biliary tract during the long-term follow-up of patients with pancreaticobiliary maljunction after they have undergone a choledochojejunostomy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Seki M, Yanagawa A, Ninomiya E, Ninomiya Y, Ohta H, Saiura A, et al. Clinicopathology of pancreaticobiliary maljunction: relationship between alteration in background biliary epithelium and neoplastic development. J Hepatobiliary Pancreat Surg 2005;12:254–262.
Sugiyama M, Atomi Y, Kuroda A. Pancreatic disorders associated with anomalous pancreaticobiliary junction. Surgery 1999;126:492–497.
Todani T, Watanabe Y, Urushihara N, Noda T, Morotomi Y. Choledochal cyst, pancreaticobiliary malunion, and cancer. J Hepatobiliary Pancreat Surg 1994;1:247–251.
Ueda N, Nagakawa T, Ohta T, Tugawa K, Takeda T, Kadoya N, et al. A case of carcinomas of the gallbladder, common bile duct and pancreas associated with anomalous arrangement of the pancreaticobiliary ductal system (in Japanese with English abstract). Nippon Rinsyou Geka Gakkai Zasshi (J Jpn Surgical Association) 1988;49:2198–2205.
Kunimura T, Morohoshi T, Kanda M, Kuroki T, Umezawa T, Asanuma K. Anomalous arrangement of pancreatobiliary ductal system associated with gallbladder and pancreatic cancer (in Japanese with English abstract). Tando (J Jpn Biliary Association) 1990;4:68–74.
Morohoshi T, Kunimura T, Kanda M, Takahashi H, Yagi H, Shimizu K, et al. Multiple carcinoma associated with anomalous arrangement of the biliary and pancreatic duct system. Acta Pathol Jpn 1990;40:755–763.
Okada S, Tanaka S. A case of pancreatobiliary maljunction with metachronous double cancer of the gallbladder and pancreas (in Japanese). Syujutu (Operation) 1992;46:12:1903–1909.
Mayumi K, Tanaka H, Hirohashi K, Kubo S, Wakasa K, Kinoshita H. A case of metachronous double cancer of the gallbladder and pancreas with pancreatobiliary maljunction (in Japanese). Syujutsu (Operation) 2001;55:577–588.
Kobayashi T, Kamikawa Y, Ueyama S, Satomoto K, Tamura H, Yoshinaga F, et al. A case of anomalous arrangement of the pancreaticobiliary ductal system associated with carcinomas of gallbladder and pancreas (in Japanese). Tan To Sui (J Bil Pancr) 2002;23:941–947.
Author information
Authors and Affiliations
About this article
Cite this article
Minami, Y., Hasuike, Y., Takeda, Y. et al. Metachronous double cancer of the gallbladder and pancreas associated with pancreaticobiliary maljunction. J Hepatobiliary Pancreat Surg 15, 330–333 (2008). https://doi.org/10.1007/s00534-007-1208-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00534-007-1208-7