[Gallbladder carcinomas with a single lymph node involvement behind biliary tract -two resected cases].
Case 1 was an 85-year-old man, who was pointed out a gallbladder tumor by screening CT scan after bladder cancer. The tumor was arisen in the gallbladder body, 1 .5 cm in diameter. He underwent a radical surgery; the gallbladder-bed was resected with more than 1 cm margin, and lymphadenectomy was done preserving biliary tract. Pathologically his tumor was papillary adenocarcinoma suspected to invade to the liver-bed minimally. A lymph node involvement was solitary located at right side of hepatoduodenal ligament (behind biliary tract). Case 2 was a 73-year-old man who was pathologically diagnosed to be advanced gallbladder carcinoma after laparoscopic cholecystectomy. CT scan and MRI revealed a mass sized 2 cm in diameter, at the gallbladder-bed, and PET exam showed a hot spot at this site only. Therefore, he underwent a radical surgery like case 1. Pathologically the tumor was moderately differentiated adenocarcinoma, and a lymph node involvement was solitary and located behind a biliary tract. Both patients have been recurrent free for more than 22 months and 15 months, respectively. Two lymphatic drainage routes have been suggested, one is the route which runs right side of hepatoduodenal ligament, another runs via left side of the ligament, along hepatic artery. Our two cases are considered to be solitary metastatic cases along the right side route. A clinical case of solitary node positive seems to be known for its relatively good prognosis. In order to justify our cases, we need a longer follow-up period, or we should have more cases to be experienced.
Dept. of Surgery, Yao Municipal Hospital.
Shigekazu
S
Yokoyama
Yo
Y
Sasaki
Kazuhiko
K
Hashimoto
Reishi
R
Toshiyama
Shuichi
S
Fukuda
Atsushi
A
Naito
Shinji
S
Matsumoto
Masayoshi
M
Tokuoka
Yoshihito
Y
Ide
Jin
J
Matsuyama
Takashi
T
Morimoto
Yukio
Y
Fukushima
Takashi
T
Nomura
Masashi
M
Takeda
D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D001659:Biliary Tract / Q000473:pathology*; D005706:Gallbladder Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging