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Mucosal bile duct carcinoma with superficial spread
Author(s) -
Iwahashi Naoko,
Hayakawa Naokazu,
Yamamoto Hideo,
Maki Atsuhiko,
Kawabata Yasuji,
Murayama Akiko,
Nimura Yuji,
Kamiya Junichi,
Nagino Masato,
Mori Naoharu
Publication year - 1998
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s005340050038
Subject(s) - medicine , papillary adenocarcinoma , bile duct carcinoma , papillary tumor , bile duct , common bile duct , carcinoma , malignancy , adenocarcinoma , bile duct cancer , lymph node , major duodenal papilla , pancreaticoduodenectomy , jaundice , percutaneous transhepatic cholangiography , pathology , cholangiography , radiology , gastroenterology , cancer , pancreas
We describe a case of mucosal bile duct carcinoma with superficial spread in a 69‐year‐old man with gallstone pancreatitis. The patient was seen at the hospital because of abdominal pain, fever, and jaundice. Endoscopic retrograde cholangiography (ERC) demonstrated a protruding lesion in the lower third of the common bile duct (CBD) showing wall irregularity suggestive of malignancy. Percutaneous transhepatic cholangioscopy (PTCS) disclosed a papillary tumor with granular mucosa extending continuously to the middle third of the CBD. Cholangioscopic biopsy specimens taken from both the papillary tumor and surrounding granular mucosa revealed papillary adenocarcinoma. After this assessment of extent of cancer by PTCS, we performed pancreatoduodenectomy with extrahepatic bile duct resection and regional lymph node dissection. Pathology examination revealed papillary adenocarcinoma limited to the mucosal layer. The resected margin of the bile duct was free of tumor. We also reviewed 25 cases of early mucosal bile duct carcinoma described in detail in the Japanese literature, and we discuss the diagnostic advantages of PTCS.