title: Synchronous cancer of the biliary tract and pancreas associated with anomalous arrangement of the pancreaticobiliary ductal system.
abstract: A 58-year-old man on abdominal ultrasonography and CT had an irregularly elevated lesion at the neck of the gallbladder and a cyst of approximately 6.5 cm in diameter at the pancreatic tail. Percutaneous transhepatic cholangiography revealed a 2-cm shadow defect at the neck of the gallbladder and an irregular, translucent 30 x 12 mm lesion in the intrapancreatic bile duct. Total pancreatectomy and extended cholecystectomy with regional lymph node dissection was performed. An anomalous arrangement of the pancreaticobiliary ductal system (AAPBD) was demonstrated by postoperative contrast radiography of resected specimen. The lesions of the gallbladder and common bile duct were papillary adenocarcinoma. In addition, papillary adenocarcinoma was limited almost entirely to the mucosal layer of the main pancreatic duct and its branches, from the junction of the common bile duct and pancreatic duct to the pancreatic tail. The three tumors were not continuous. The cyst at the pancreatic tail was a pseudocyst. This case represents synchronous cancer of the gallbladder, common bile duct, and pancreas associated with AAPBD.
authors.affiliation: Second Department of Surgery, School of Medicine, Kanazawa University, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Ueda
authors.forename: T
authors.initials: T
authors.lastname: Nagakawa
authors.forename: T
authors.initials: T
authors.lastname: Ohta
authors.forename: M
authors.initials: M
authors.lastname: Kayahara
authors.forename: K
authors.initials: K
authors.lastname: Ueno
authors.forename: I
authors.initials: I
authors.lastname: Konishi
authors.forename: R
authors.initials: R
authors.lastname: Izumi
authors.forename: I
authors.initials: I
authors.lastname: Miyazaki
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000473:pathology*; D001652:Bile Ducts / Q000002:abnormalities*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003135:Common Bile Duct / Q000000981:diagnostic imaging / Q000473:pathology; D003138:Common Bile Duct Neoplasms / Q000473:pathology*; D005704:Gallbladder / Q000473:pathology; D005706:Gallbladder Neoplasms / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010183:Pancreatic Ducts / Q000002:abnormalities* / Q000000981:diagnostic imaging; D010190:Pancreatic Neoplasms / Q000473:pathology*