title: [Case of intrahepatic cholangiocarcinoma drained through a fistula of the duodenal bulb].
abstract: A 72-year-old woman presented with epigastric discomfort. A low density tumor was found in the hilum and left liver by CT. Since she complained epigastralgia, upper gastrointestinal endoscopy was performed, showing an ulcer in the duodenal bulb, with poorly-differentiated adenocarcinoma seen on a biopsy specimen from the edge of the ulcer. After admission, poorly-differentiated adenocarcinoma cells were also obtained with ultrasound guided aspiration cytology of the liver tumor. We diagnosed intrahepatic cholangiocarcinoma (IHC), and treated with gemcitabine. During chemotherapy, the duodenal ulcer became a fistula, and the liver tumor diminished with bubbles inside it. It was suggested that liquid material of IHC, such as necrotic tissue and mucin, drained to the duodenal bulb during chemotherapy.
authors.affiliation: Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Tomizawa
authors.forename: Toshio
authors.initials: T
authors.lastname: Tsuyuguchi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sakai
authors.forename: Harutoshi
authors.initials: H
authors.lastname: Sugiyama
authors.forename: Kaoru
authors.initials: K
authors.lastname: Miyakawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ishihara
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000188:drug therapy / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000188:drug therapy / Q000473:pathology; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D004378:Duodenal Diseases / Q000473:pathology*; D004379:Duodenal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000473:pathology*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000473:pathology; D009361:Neoplasm Invasiveness; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine