title: Large-cell neuroendocrine carcinoma of the distal bile duct.
abstract: Large-cell neuroendocrine carcinoma (LCNEC) in the distal bile duct is very rare and different from common distal bile duct adenocarcinoma. A 77-year-old man was admitted with obstructive jaundice. Severe stenosis of the distal bile duct was revealed by percutaneous transhepatic cholangiography. Subtotal stomach-preserving pancreaticoduodenectomy was performed. A tumor measuring 1.8 cm in diameter was located in the distal bile duct. Both histopathological and immunohistochemical examination of the resected specimen revealed features of LCNEC of the bile duct. The patient developed multiple liver metastases, lung metastases, and local recurrence and died of disease 3 months after the operation. The clinical behavior of LCNEC in the distal bile duct appears to be highly aggressive with early metastases and a fatal outcome.
authors.affiliation: Department of General Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujinakanda, Minami-ku, Hiroshima, 734-8530, Japan. tkohashi@mail.goo.ne.jp.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Kohashi
authors.affiliation: Department of General Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujinakanda, Minami-ku, Hiroshima, 734-8530, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Matsugu
authors.affiliation: Department of General Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujinakanda, Minami-ku, Hiroshima, 734-8530, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakahara
authors.affiliation: Department of General Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujinakanda, Minami-ku, Hiroshima, 734-8530, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Ohmori
authors.affiliation: Department of General Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujinakanda, Minami-ku, Hiroshima, 734-8530, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Egi
authors.affiliation: Department of General Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujinakanda, Minami-ku, Hiroshima, 734-8530, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Urushihara
authors.affiliation: Department of Pathology, Hiroshima Prefectural Hospital, 1-5-54 Ujinakanda, Minami-ku, Hiroshima, 734-8530, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nishisaka
authors.affiliation: Department of Pathology, Hiroshima Prefectural Hospital, 1-5-54 Ujinakanda, Minami-ku, Hiroshima, 734-8530, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Fukuhara
authors.affiliation: Department of General Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujinakanda, Minami-ku, Hiroshima, 734-8530, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Fukuda
keywords: Distal bile duct; Large-cell neuroendocrine carcinoma; Pancreaticoduodenectomy; Small-cell carcinoma