Abnormal arrangement of the pancreato-biliary ductal system associated with advanced gallbladder cancer diagnosed 3 years after follow-up ultrasonography.
We herein report a case of abnormal arrangement of the pancreato-biliary ductal system (AAPB) followed by advanced gallbladder cancer 9 years after the initial endoscopic retrograde cholangiopancreatography (ERCP) diagnosis and almost 3 years after follow-up ultrasonography (US). A 65-year-old woman was referred to our department from a private clinic because of difficulty in controlling her diabetes mellitus. The patient had no complaints, and physical examination revealed no jaundice in her skin or conjunctiva. ERCP demonstrated the presence of AAPB (bile duct-main type) without congenital dilatation of the bile duct or irregularity in the gallbladder wall. She did not wish to undergo cholecystectomy. Follow-up transabdominal US revealed no change in the gallbladder. Two years and 9 months after this US examination, she developed advanced gallbladder cancer involving the liver and bile duct, with paraaortic lymph node metastases confirmed by US, computed tomography, and ERCP. This case re-emphasizes the necessity for patients with AAPB to undergo intensive follow-up examinations or cholecystectomy when the diagnosis of AAPB has been established.
Fujita
Naotaka
N
Department of Gastroenterology, Sendai City Medical Center, 5-22-1 Tsurugaya, Miyagino-ku, Sendai 983-0824, Japan.
Noda
Yutaka
Y
Kobayashi
Go
G
Kimura
Katsumi
K
Ito
Kei
K
Sugawara
Toshiki
T
Horaguchi
Jun
J
D000368:Aged; D001652:Bile Ducts / Q000002:abnormalities*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003266:Continuity of Patient Care; D017809:Fatal Outcome; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D010183:Pancreatic Ducts / Q000002:abnormalities*; D013997:Time Factors; D014463:Ultrasonography