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A Case of Early Gallbladder Carcinoma Associated with the Anomalous Union of the Pancreaticobiliary Ductal System
Author(s) -
TAKIUCHI Hiroya,
TADA Hideki,
TAKEDA Yoshinobu,
TEI Hogen,
HASHIMURA Naotaka,
ASHIDA Kiyoshi,
ASADA Syuji,
HIRATA Ichirou,
OHSHIBA Saburo,
NABESHIMA Toshiya,
MASAKI Keiko,
NAITOH Kazuma
Publication year - 1991
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1991.tb00263.x
Subject(s) - medicine , gallbladder , cholecystectomy , intestinal metaplasia , gastroenterology , metaplasia , carcinoma , common bile duct , pathology , stomach
A 68 year‐old woman was admitted to our hospital with a high fever. Ultrasonography revealed the presence of two protruded mass lesions in the fundus of the gallbladder. Endoscopic retrograde choledochopancreatography (ERCP) indicated an anomalous union of the pancreaticobiliary ductal system (AUPD), with an anomalous junction heated at the site 30 mm proximal to the ampulla of Vater. ERCP also showed the presence of three flat elevated lesions at the fundus of the gallbladder. Amylase activity in the bile obtained from the common bile duct during ERCP was high. From these findings, gallbladder carcinoma associated with AUPD was suspected. Cholecystectomy, choledochectomy followed by hepaticojejunostomy were performed on this patient. A microscopic study of the resected gallbladder demonstrated adenocarcinoma with epithelia like intestinal metaplasia in those elevated lesions surrounded by mucosa associated with atypical hyperplasia without intestinal metaplasia. The authors believe that intestinal metaplasia is the main change accompanied by the cancer, but atypical hyperplasia was an important pre‐cancerous lesion in this case.