title: Immunohistochemical Examination of a Resected Advanced Hilar Cholangiocarcinoma Arising in a 29-Year-Old Male without Primary Sclerosing Cholangitis.
abstract: A 29-year-old man with advanced hilar cholangiocarcinoma was successfully treated with an extended right lobectomy. The carbohydrate antigen 19-9 (CA19-9) level was elevated to 939 IU/l, and the pathological findings revealed moderately differentiated tubular adenocarcinoma which involved almost the entire thickness of the hepatic duct and the adjacent liver tissue (T3) and which was associated with lymph node metastasis (N1). It was a stage IIB (T3N1M0) tubular adenocarcinoma according to UICC pathological staging. Immunohistochemical examination revealed that Ki-67, cyclin D1, and MMP-7 were positive, and 14-3-3sigma and p27 were negative. The pathological and immunohistochemical findings indicated high malignant potential indicating poor prognosis. We administrated the postoperative adjunct gemcitabine combined with S-1 chemotherapy. The patient is alive without recurrence and doing well two years after surgery. We also review other reports of cholangiocarcinoma patients aged less than 30 years.
authors.affiliation: Department of Surgery, Saiseikai Yahata General Hospital, Kitakyushu, Japan.
authors.forename: Taketoshi
authors.initials: T
authors.lastname: Suehiro
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsumata
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Iguchi
authors.forename: Kensaku
authors.initials: K
authors.lastname: Sanefuji
authors.forename: Ken-Ichi
authors.initials: KI
authors.lastname: Nomoto
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
references.citation: Ann Surg. 2004 Jul;240(1):95-101
references.pmid: 15213624
references.citation: Am J Gastroenterol. 2007 Aug;102(8):1677-82
references.pmid: 17433022
references.citation: Am J Clin Pathol. 2005 Oct;124(4):512-8
references.pmid: 16146811
references.citation: Am J Surg. 2004 Apr;187(4):559-63
references.pmid: 15041513
references.citation: Br J Cancer. 2006 Jun 5;94(11):1575-9
references.pmid: 16721372
references.citation: Hepatology. 2001 May;33(5):1118-23
references.pmid: 11343239
references.citation: Ann Oncol. 2004 May;15(5):770-4
references.pmid: 15111345
references.citation: J Clin Pathol. 2005 Dec;58(12):1249-54
references.pmid: 16311342
references.citation: J Gastrointest Surg. 2009 Jan;13(1):85-92
references.pmid: 18704593
references.citation: Br J Cancer. 2004 Nov 15;91(10):1769-74
references.pmid: 15505626
references.citation: Cancer. 2002 Jan 15;94(2):428-34
references.pmid: 11900228
references.citation: Ann Surg. 2007 May;245(5):755-62
references.pmid: 17457168
references.citation: Ann Surg. 2001 Mar;233(3):385-92
references.pmid: 11224627
references.citation: J Hepatobiliary Pancreat Surg. 2009;16(1):1-7
references.pmid: 19110652
references.citation: Arch Surg. 2004 May;139(5):514-23; discussion 523-5
references.pmid: 15136352
references.citation: Ann Surg. 2003 Nov;238(5):720-7
references.pmid: 14578735
references.citation: Ann Surg. 2008 Aug;248(2):273-9
references.pmid: 18650638
references.citation: World J Surg. 2007 Jun;31(6):1256-63
references.pmid: 17453285
references.citation: Hum Pathol. 2007 Jul;38(7):1014-1022
references.pmid: 17391729
references.citation: J Hepatol. 2001 Jul;35(1):74-9
references.pmid: 11495045
references.citation: Cancer Chemother Pharmacol. 2006 May;57(5):647-53
references.pmid: 16142487
references.citation: Ann Surg. 2001 Oct;234(4):507-17; discussion 517-9
references.pmid: 11573044