title: Synchronous malignancies of the gall bladder and common bile duct: a case report.
abstract: BACKGROUND
  Synchronous malignancies of the gall bladder and common bile duct are a rare entity. Much of our knowledge on this topic comes from Japanese literature. Most of the synchronous carcinomas described in Japanese literature are associated with the presence of an anomalous pancreatic-bile duct junction (APBDJ).
  
  
  METHODS
  We report a case of synchronous malignancy of the extrahepatic biliary tree involving the fundus of the gall bladder and the intrapancreatic portion of the common bile duct (CBD). A 50-year-old female patient presented to us with clinical features of obstructive jaundice and on radiological evaluation was diagnosed to have a periampullary carcinoma; the patient underwent a pancreaticoduodenectomy, and histopathological examination revealed adenocarcinoma of the gall bladder and the intrapancreatic portion of the CBD.
  
  
  CONCLUSIONS
  Synchronous malignancies have been rarely reported from the Indian subcontinent; therefore, it is essential for the clinician as well as the pathologist to maintain a high index of suspicion while evaluating such lesions and to look for the presence of an anamolous pancreatic-bile duct junction whenever indicated.
authors.affiliation: Department of General Surgery, KIMS, Hubli, Karnataka, 580022, India. srinirocks89@gmail.com.
authors.forename: Srinivas
authors.initials: S
authors.lastname: Kodaganur
authors.affiliation: Department of General Surgery, KIMS, Hubli, Karnataka, 580022, India.
authors.forename: Ishwar R
authors.initials: IR
authors.lastname: Hosamani
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D001650:Bile Duct Neoplasms / Q000473:pathology* / Q000601:surgery; D017734:Bile Ducts, Extrahepatic / Q000473:pathology* / Q000601:surgery; D003135:Common Bile Duct / Q000473:pathology* / Q000601:surgery; D005260:Female; D005706:Gallbladder Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D011379:Prognosis
keywords: Anamolous pancreatic-bile duct junction (APBDJ); Gall bladder carcinoma; Pancreaticoduodenectomy; Periampullary carcinoma; Synchronous malignancies