title: A case of extrahepatic bile duct wall recurrence of gastric carcinoma that was treated with pancreaticoduodenectomy.
abstract: We report on a patient with obstructive jaundice caused by recurrence of gastric carcinoma in the wall of an extrahepatic bile duct more than 5 years after gastrectomy who was treated with pancreaticoduodenectomy. Histopathologic examination of the surgically resected specimen revealed a poorly differentiated adenocarcinoma with focal signet ring cells in the wall of the common bile duct which was histologically similar to the primary gastric carcinoma. To confirm the diagnosis, immunohistochemical staining was performed with antibodies against cytokeratins (CK7, CK20) and mucin peptide core antigens (MUC5AC, MUC6, MUC2). Based on the expression patterns of this monoclonal antibody panel, the final diagnosis of the common bile duct tumor was an isolated local recurrence of the gastric carcinoma. The patient has survived for more than 26 months after pancreaticoduodenectomy without recurrence.
authors.affiliation: Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, Japan. stakashi@nms.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Shirakawa
authors.forename: Kimiyoshi
authors.initials: K
authors.lastname: Yokoi
authors.forename: Tomoko
authors.initials: T
authors.lastname: Seya
authors.forename: Masato
authors.initials: M
authors.lastname: Yoshioka
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Ohaki
authors.forename: Eiji
authors.initials: E
authors.lastname: Uchida
mesh_terms: D017734:Bile Ducts, Extrahepatic / Q000473:pathology*; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D041781:Jaundice, Obstructive / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D007633:Keratins / Q000096:biosynthesis; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D009077:Mucins / Q000096:biosynthesis; D016577:Pancreaticoduodenectomy / Q000379:methods*; D012008:Recurrence; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D009077:Mucins; D007633:Keratins