Abstract
We report herein a case of recurrent mucosal cancer of the extrahepatic bile duct, with superficial flat spread, 12 years after operation. A 67-year-old woman had undergone common bile duct (CBD) resection and Roux-en-Y reconstruction. Histologically, the tumor was papillary adenocarcinoma, with superficial flat spread, with no invasive component. The epithelium at the distal margin had been exfoliated, so the absence or presence of any remnant cancerous lesion was unclear. But the superficial flat spread had expanded to within at least 3 mm from the distal margin. About 12 years postoperatively, she was hospitalized with upper abdominal pain, and duodenoscopy demonstrated a tumor in the second portion of the duodenum. Biopsy identified adenocarcinoma. Computed tomography showed a low-density mass between the duodenum and pancreatic head. Pancreatoduodenectomy was performed. Histologically, papillary adenocarcinoma was found within the whole of the intrapancreatic bile duct, and its histological appearance resembled that of the original tumor. Moderately differentiated tubular adenocarcinoma had invaded around the tissue of the intrapancreatic CBD. These findings suggest that remnant intramucosal flat carcinoma within the intrapancreatic bile duct had developed into invasive carcinoma over the course of 12 years. This case suggests that remnant intraepithelial flat carcinoma within the CBD may develop a late local recurrence.
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SW Park YS Park JB Chung KJ Kang KS Kim JS Choi et al. (2004) ArticleTitlePatterns and relevant factors of tumor recurrence for extrahepatic bile duct carcinoma after radical resection Hepatogastroenterology 51 1612–8 Occurrence Handle15532789
T Wakai Y Shirai T Moroda N Yokoyama K Hatakeyama (2005) ArticleTitleImpact of ductal resection margin status on long-term survival on patients undergoing resection for extrahepatic cholangiocarcinoma Cancer 103 1210–6 Occurrence Handle15685618 Occurrence Handle10.1002/cncr.20906
E Sakamoto Y Nimura N Hayakawa J Kamiya S Kondo M Nagino et al. (1998) ArticleTitleThe pattern of infiltration at the proximal border of hilar bile duct carcinoma Ann Surg 227 405–11 Occurrence Handle9527064 Occurrence Handle1:STN:280:DyaK1c7os1aqsQ%3D%3D Occurrence Handle10.1097/00000658-199803000-00013
Y Nimura (1993) ArticleTitleStaging of biliary carcinoma: cholangiography and cholangioscopy Endoscopy 25 76–80 Occurrence Handle8384103 Occurrence Handle1:STN:280:ByyB3c3gs1c%3D Occurrence Handle10.1055/s-2007-1009128
MR Bhuiya Y Nimura J Kamiya S Kondo M Nagino N Hayasaka (1993) ArticleTitleCarcinoma of the hepatic hilus with superficial spreading to the intrahepatic segmental bile ducts J Hepatobiliary Pancreat Surg 1 22–6 Occurrence Handle10.1007/BF01235930
N Iwahashi N Hayakawa H Yamamoto A Maki Y Kawabata A Murayama et al. (1998) ArticleTitleMucosal bile duct carcinoma with superficial spread J Hepatobiliary Pancreat Surg 5 221–5 Occurrence Handle9745093 Occurrence Handle1:STN:280:DyaK1M%2FivFGiug%3D%3D Occurrence Handle10.1007/s005340050038
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Nakanishi, Y., Kondo, S., Hirano, S. et al. Recurrence of mucosal carcinoma of the bile duct, with superficial flat spread, 12 years after operation. J Hepatobiliary Pancreat Surg 13, 355–358 (2006). https://doi.org/10.1007/s00534-006-1092-6
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DOI: https://doi.org/10.1007/s00534-006-1092-6