Metachronous bile duct cancer nine years after resection of gallbladder cancer.
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.
Joo
Hye Jin
HJ
Department of Internal Medicine, College of Medicine, Chungbuk National University, Gaeshindong 62, Heungdukgu, Cheongju 361-711, South Korea.
Kim
Gi Hyun
GH
Jeon
Won Joong
WJ
Chae
Hee Bok
HB
Park
Seon Mee
SM
Youn
Sei Jin
SJ
Choi
Jae Woon
JW
Sung
Rohyun
R
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