title: Anastomotic recurrence at hepaticojejunostomy in a long-term survivor of bile duct carcinoma: report of a case.
abstract: A rare case of autopsy-proven recurrence 10 years after a radical resection for lower bile duct carcinoma is herein reported. The subject is a 53-year-old man who underwent a curative resection of distal bile duct carcinoma with pancreatoduodenectomy in 1981. The lesion was a 1.0 x 1.5 x 1.0 cm well-differentiated papillotubular adenocarcinoma invading the fibromuscular layer of the bile duct with a slight infiltration to the lymphatics but without any extension to the vessels, nerves, connective tissues, or nodes. The patient demonstrated a recurrence 10 years after the initial operation and died 4 months later. An autopsy revealed a 2.0 x 2.5 x 1.6 cm mass at the anastomotic site of hepaticojejunostomy without any distant metastases. Although a late anastomotic recurrence after more than 10 years is unique, this case highlights the difficulty of the operative eradication of bile duct carcinoma. As a result, all possible maneuvers either during or after operation to promote the prophylaxis of recurrence are warranted.
authors.affiliation: Department of Surgery, Asahi General Hospital, Chiba, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Tanaka
authors.forename: M
authors.initials: M
authors.lastname: Nobori
authors.forename: T
authors.initials: T
authors.lastname: Kohzuma
authors.forename: Y
authors.initials: Y
authors.lastname: Suzuki
authors.forename: S
authors.initials: S
authors.lastname: Saiki
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000473:pathology / Q000601:surgery*; D000714:Anastomosis, Surgical; D003138:Common Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D004386:Duodenum / Q000601:surgery; D006801:Humans; D007583:Jejunum / Q000473:pathology / Q000601:surgery*; D008099:Liver / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D010179:Pancreas / Q000601:surgery