title: Bile duct carcinoma recurrence in the papillary region in a long-term survivor of hilar cholangiocarcinoma: a case report.
abstract: BACKGROUND
  Because of its high rate of early recurrence and its poor prognosis, long-term survival after cholangiocarcinoma is rare; therefore, only limited information on patients surviving more than 5 years after surgical therapy is available.
  
  
  METHODS
  We report the case of a 57-year-old white man who developed a distal bile duct carcinoma 9 years after curative surgical therapy of intrahepatic cholangiocarcinoma. He had undergone a right lobe hemihepatectomy 11 years ago. Nine years later, he was diagnosed with a distal bile duct carcinoma and a duodenopancreatectomy was performed. On histologic examination both carcinomas revealed a tubular and papillary growth pattern with cancer-free resection margins and for both carcinomas there were no signs of lymphatic infiltration or metastatic spreading. Targeted next-generation sequencing showed an identical activating mutation pattern in both carcinomas.
  
  
  CONCLUSIONS
  Late recurrence of cholangiocarcinoma, even anatomically distant to the primary, in long-time survivors is possible and could be caused by a distinct tumor biology. A better understanding of the individual tumor biology could help hepatologists as well as hepatobiliary and pancreatic surgeons in their daily treatment of these patients.
authors: Department of General, Visceral and Cancer Surgery, University of Cologne, Kerpenerstr. 62, 50637, Cologne, Germany. Denise.buchner@uk-koeln.de.
authors: D
authors: D
authors: Buchner
authors: Department of General Pathology and Pathological Anatomy, University of Cologne, Cologne, Germany.
authors: U
authors: U
authors: Drebber
authors: Department of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany.
authors: D H
authors: DH
authors: Chang
authors: Department of General, Visceral and Cancer Surgery, University of Cologne, Kerpenerstr. 62, 50637, Cologne, Germany.
authors: D L
authors: DL
authors: Stippel
mesh_terms: D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D001652:Bile Ducts / Q000000981:diagnostic imaging / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003952:Diagnostic Imaging; D006500:Hepatic Duct, Common / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D018285:Klatskin Tumor / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000628:therapy*
keywords: Case report; Cholangiocarcinoma; Recurrence; Surgical therapy; Targeted next-generation sequencing