title: Metachronous bile duct cancer nine years after resection of gallbladder cancer.
abstract: We report a rare case of a 74-year-old man with metachronous gallbladder cancer and bile duct cancer who underwent curative resection twice, with the operations nine years apart. At the age of 65 years, the patient underwent a cholecystectomy and resection of the liver bed for gallbladder cancer. This was a well-differentiated adenocarcinoma, with negative resection margins (T2N0M0, stage IB). Nine years later, during a follow-up examination, abdominal computed tomography and MRCP showed an enhanced 1.7 cm mass in the hilum that extended to the second branch of the right intrahepatic bile duct. We diagnosed this lesion as a perihilar bile duct cancer, Bismuth type IIIa, and performed bile duct excision, right hepatic lobectomy and Roux-en-Y hepaticojejunostomy. The histological diagnosis was a well-differentiated adenocarcinoma with one regional lymph node metastasis (T1N1M0, stage IIB). Twelve months after the second operation, the patient is well, with no signs of recurrence. This case is compared with 11 other cases of metachronous biliary tract cancer published in the world medical literature.
authors.affiliation: Department of Internal Medicine, College of Medicine, Chungbuk National University, Gaeshindong 62, Heungdukgu, Cheongju 361-711, South Korea.
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Joo
authors.forename: Gi Hyun
authors.initials: GH
authors.lastname: Kim
authors.forename: Won Joong
authors.initials: WJ
authors.lastname: Jeon
authors.forename: Hee Bok
authors.initials: HB
authors.lastname: Chae
authors.forename: Seon Mee
authors.initials: SM
authors.lastname: Park
authors.forename: Sei Jin
authors.initials: SJ
authors.lastname: Youn
authors.forename: Jae Woon
authors.initials: JW
authors.lastname: Choi
authors.forename: Rohyun
authors.initials: R
authors.lastname: Sung
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000473:pathology* / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D005706:Gallbladder Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult