title: Signet-ring cell carcinoma coexisting with adenocarcinoma arising in a choledochal cyst: report of a case.
abstract: Signet-ring cell carcinoma (SRCC) is rare in the biliary system. We report a case of SRCC coexisting with adenocarcinoma, arising in a choledochal cyst of the extrahepatic bile duct. The patient was a 52-year-old man, hospitalized for the investigation of jaundice and pruritus. Abdominal computed tomography and magnetic resonance cholangiopancreatography showed a huge choledochal cyst and distal common bile duct cancer. The patient underwent a pancreaticoduodenectomy with extended lymph node dissection. Histologic examination confirmed an SRCC coexisting with adenocarcinoma arising in a choledochal cyst. Postoperative chemotherapy had to be discontinued after only two cycles because the patient suffered serious side effects. Recurrence was detected in the bilioenteric anastomosis 4 months after surgery, and he died 6 months after surgery. To our knowledge, this represents the first case of SRCC arising in a choledochal cyst of the extrahepatic bile duct ever to be reported.
authors.affiliation: Department of Biliary-Pancreatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Hua
authors.forename: Jun-feng
authors.initials: JF
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.forename: Yan-miao
authors.initials: YM
authors.lastname: Huo
authors.forename: Yong-wei
authors.initials: YW
authors.lastname: Sun
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000601:surgery*; D017734:Bile Ducts, Extrahepatic / Q000601:surgery*; D018279:Carcinoma, Signet Ring Cell / Q000175:diagnosis / Q000601:surgery*; D049448:Cholangiopancreatography, Magnetic Resonance; D015529:Choledochal Cyst / Q000175:diagnosis / Q000601:surgery*; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis / Q000601:surgery*; D017809:Fatal Outcome; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D016577:Pancreaticoduodenectomy; D012008:Recurrence