Usefulness of MR imaging in the postsurgical monitoring of gallbladder cancer in a patient with bile duct cancer that developed 7 years after resection of mucinous adenocarcinoma of the gallbladder.
We encountered a case of left hepatic duct cancer that developed 7 years after surgical resection of early-stage adenocarcinoma of the gallbladder. A 65-year-old woman was hospitalized with high fever and general fatigue. She also had elevated serum levels of alkaline phosphatase, gamma-glutamyltranspeptidase, and carbohydrate antigen 19-9. Seven years earlier, she had undergone extended cholecystectomy and resection of the extrahepatic bile duct for early-stage mucinous adenocarcinoma of the gallbladder. Conventional examinations did not reveal any responsible lesions. Magnetic resonance (MR) cholangiography, however, showed a tumor obstructing the left hepatic duct, and dynamic MR images revealed multiple foci of bacterial abscess in the liver. Surgically resected tissue again revealed mucinous adenocarcinoma. The present case is rare in that metachronous mucinous adenocarcinoma of the biliary system occurred after a long interval. This case suggests the usefulness of MR imaging in the postsurgical monitoring of patients with gallbladder carcinoma.
Takai
S
S
First Department of Internal Medicine, Gifu University School of Medicine, Japan.
Shiratori
Y
Y
Kanematsu
M
M
Yamazaki
K
K
Naiki
T
T
Yasuda
I
I
Nagaki
M
M
Murakami
N
N
Kato
T
T
Takao
H
H
Shimokawa
K
K
Hoshi
H
H
Saji
S
S
Moriwaki
H
H
D002288:Adenocarcinoma, Mucinous / Q000473:pathology* / Q000601:surgery*; D000368:Aged; D001650:Bile Duct Neoplasms / Q000473:pathology* / Q000601:surgery*; D002758:Cholangiography; D005260:Female; D005706:Gallbladder Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D016609:Neoplasms, Second Primary / Q000473:pathology* / Q000601:surgery*; D011182:Postoperative Care