title: Curative resection of hilar cholangiocarcinoma in a 25-year-old woman: report of a case.
abstract: A 25-year-old woman was referred to our hospital with persistent upper abdominal pain. Preoperative imaging studies revealed a hilar bile duct stricture with portal venous encasement, and the patient underwent curative resection involving extended left hepatectomy and segmental portal vein resection. The pathological findings demonstrated a well-differentiated tubular adenocarcinoma of the bile duct with regional lymph node metastasis (stage IIIB according to the UICC TNM classification), as well as the overexpression of p53 proteins and the K-ras gene mutation in tumor cells. The patient has shown no evidence of recurrence in the 10 months since the operation. Although there are several reports of relatively young adults with cholangiocarcinoma, the majority of such patients demonstrate either an anomalous arrangement of the pancreaticobiliary duct system or primary sclerosing cholangitis. The absence of any morphological abnormalities in this patient's biliary system implicates de novo carcinogenesis as the most likely cause of the cholangiocarcinoma.
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan, smura@med.kobe-u.ac.jp.
authors.forename: Sae
authors.initials: S
authors.lastname: Murakami
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ajiki
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Ueno
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Sawa
authors.forename: Shinobu
authors.initials: S
authors.lastname: Tsuchida
authors.forename: Izuru
authors.initials: I
authors.lastname: Otsubo
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Kenta
authors.initials: K
authors.lastname: Shinozaki
authors.forename: Taro
authors.initials: T
authors.lastname: Okazaki
authors.forename: Ippei
authors.initials: I
authors.lastname: Matsumoto
authors.forename: Takumi
authors.initials: T
authors.lastname: Fukumoto
authors.forename: Yonson
authors.initials: Y
authors.lastname: Ku
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D001652:Bile Ducts / Q000002:abnormalities; D001653:Bile Ducts, Intrahepatic; D017024:Chemotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D011905:Genes, ras / Q000235:genetics; D006498:Hepatectomy; D006801:Humans; D008207:Lymphatic Metastasis; D009154:Mutation; D009367:Neoplasm Staging; D010183:Pancreatic Ducts / Q000002:abnormalities; D011169:Portal Vein / Q000601:surgery; D016896:Treatment Outcome; D016159:Tumor Suppressor Protein p53; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D016159:Tumor Suppressor Protein p53; D003841:Deoxycytidine; D000093542:Gemcitabine