title: A case of undifferentiated carcinoma of the gallbladder with anomalous arrangement of the pancreaticobiliary ductal system.
abstract: Anomalous junction of the pancreaticobiliary duct (AJPBD) is a congenital anomaly associated with gallbladder carcinoma. Especially patients with noncystic dilatation and without dilatation of the biliary tract are at risk of gallbladder carcinoma. A 56-year-old woman with advanced gallbladder cancer associated with AJPBD but without dilatation of the biliary tract was treated at our hospital. Although histologically cancer cells remained in the layer of the proprial mucosa, extensive metastases to lymph nodes including the paraaorta and peripancreas were detected. According to the TNM classification this case was of Stage IVB. The cancer consisted of medullary round cells, and was diagnosed as undifferentiated carcinoma. After surgery poor prognosis was expected, but three years have elapsed with no recurrence. The case is of interest because of two points of discrepancy: the primary cancer did not show deep invasion but demonstrated extensive lymph node metastases; the cancer was histologically malignant but prognosis was relatively good.
authors.affiliation: Department of Internal Medicine, Kakogawa Municipal Hospital, Hyogo, Japan. yanoyo@med.kobe-u.ac.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Yano
authors.forename: K
authors.initials: K
authors.lastname: Tasaka
authors.forename: T
authors.initials: T
authors.lastname: Okutani
authors.forename: Y
authors.initials: Y
authors.lastname: Maeda
authors.forename: T
authors.initials: T
authors.lastname: Mori
authors.forename: M
authors.initials: M
authors.lastname: Tamura
authors.forename: Y
authors.initials: Y
authors.lastname: Hamada
authors.forename: T
authors.initials: T
authors.lastname: Yokoyama
authors.forename: N
authors.initials: N
authors.lastname: Maeda
authors.forename: Y
authors.initials: Y
authors.lastname: Tomofuji
authors.forename: T
authors.initials: T
authors.lastname: Morishita
authors.forename: J I
authors.initials: JI
authors.lastname: Sugihara
authors.forename: T
authors.initials: T
authors.lastname: Chinzei
mesh_terms: D001652:Bile Ducts / Q000002:abnormalities* / Q000601:surgery; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000002:abnormalities