title: Cholangiocarcinoma in a middle-aged patient working at a printing plant.
abstract: A 39-year-old male with elevated serum transferases consulted our hospital in September 2010. Since 1999, he had worked at a printing company using organic solvents. Cholangiography revealed stenosis of the left hepatic duct with peripheral dilation, stricture of the right hepatic duct, and irregularity of the extrahepatic bile duct. As a preoperative diagnosis of sclerosing cholangitis and cholangiocarcinoma was made, extended left hepatectomy with resection of the extrahepatic bile duct and anastomosis of the anterior and posterior branches of the bile duct and the jejunum (Roux-en Y reconstruction) were performed. A histological examination showed papillary carcinoma of the medial hepatic bile duct with intraductal growth, and biliary intraepithelial neoplasia-2/3 lesions from the medial hepatic bile duct to the right hepatic and the common bile ducts. Chronic cholangitis was shown around the tumors. Postoperatively, the patient was treated with adjuvant chemo-radiation, and he is doing well 30 months after the operation, without recurrence. Unknown causes, including exposure to organic solvents, might have induced chronic bile duct injury and contributed to the development of cholangiocarcinoma.
authors.forename: Shogo
authors.initials: S
authors.lastname: Tanaka
authors.forename: Nobusuke
authors.initials: N
authors.lastname: Fukumoto
authors.forename: Kohichi
authors.initials: K
authors.lastname: Ohno
authors.forename: Sayaka
authors.initials: S
authors.lastname: Tanaka
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ohsawa
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
authors.forename: Shoji
authors.initials: S
authors.lastname: Kuboo
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D059186:Chemoradiotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006498:Hepatectomy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009784:Occupational Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016273:Occupational Exposure / Q000009:adverse effects*; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011327:Printing; D012307:Risk Factors; D012997:Solvents / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D017132:Workplace
chemical_list: D012997:Solvents