title: Isolated recurrence of distal adenocarcinoma of the extrahepatic bile duct on a draining sinus scar after curative resection: case report and review of the literature.
abstract: BACKGROUND
  Surgical resection remains the gold standard for the treatment of localized adenocarcinoma of the extrahepatic bile ducts. Yet, treatment of loco-regional recurrences is not well defined.
  
  
  METHODS
  We present an unusual case of distal adenocarcinoma of the extrahepatic bile ducts that was treated with surgery and relapsed two years later with a solitary recurrence on the tract of a previous Redon drain. In addition, a review of the literature on management of loco regional relapses is presented.
  
  
  CONCLUSIONS
  The ideal management of these patients still remains undefined. Decisions are made based on clinical parameters from retrospective series, such as tumor grade, surgical margins or lymph node involvement. Prospective studies, that include molecular and genetic markers, are needed to improve patient selection and outcomes on this population.
authors.affiliation: Centro Integral Oncológico Clara Campal (CIOCC), Madrid, Spain. jesusrodriguez@hospitaldemadrid.com
authors.forename: Jesús
authors.initials: J
authors.lastname: Rodríguez-Pascual
authors.forename: Emilio
authors.initials: E
authors.lastname: De Vicente
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Quijano
authors.forename: Francisco
authors.initials: F
authors.lastname: Pérez-Rodríguez
authors.forename: Fernando
authors.initials: F
authors.lastname: Bergaz
authors.forename: Manuel
authors.initials: M
authors.lastname: Hidalgo
authors.forename: Ignacio
authors.initials: I
authors.lastname: Duran
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D001650:Bile Duct Neoplasms / Q000473:pathology* / Q000601:surgery; D017734:Bile Ducts, Extrahepatic / Q000473:pathology* / Q000601:surgery; D002921:Cicatrix / Q000473:pathology* / Q000601:surgery; D004322:Drainage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011379:Prognosis