A Successfully Resected Case of Synchronous Double Cancers in the Extrahepatic Biliary Tract Including the Findings on Immunohistochemical Staining with CEA and DNA Ploidy Pattern by Flow Cytometry

Kuniaki Aridome, Sonshin Takao, Kenji Yano, Yusei Haraguchi, Takashi Aikou, Hisaaki Shimazu

The First Department of Surgery, Kagoshima University School of Medicine

A case of synchronous double cancers in the extrahepatic biliary tract is described. A 63-year-old man was admitted to our hospital with a complaint of jaiundice, which was successfully managed with PTCD by a former doctor. PTC, ERC, CT imaging and ultrasonography revealed a tumor mass in the distal common duct and multiple stones both in the gallbladder and common bile duct. Pylorus-preserving pancreaticoduodenectomy concurrent with cholecystectomy was performed. Postoperative examination of the resected specimens indicated another tumorous lesion in the gallbladder, in addition to the distal common bile duct tumor and biliary stones. Both tumors were histopathologically diagnosed as well-differentiated tubular adenocarcinoma. However, neither connection of growth between the two tumors nor vessel invasion by the tumors was observed. Furthermore, the biological behavior of the tumors as determined by immunohistochemical staining with CEA and DNA ploidy pattern with flow cytometry was different. Thus, the tumors were considerd synchronous double cancers in the extrahepatic biliary tract. To our knowledge, only 34 such cases including our own have been reported in the Japanese literature.

Key words
synchronous double cancer, biliary tract carcinoma, carcinoembryonic antigen, DNA ploidy pattern

Reprint requests
Kuniaki Aridome First Department of Surgery, Kagoshima University School of Medicine
8-35-1 Sakuragaoka, Kagoshima, 890 JAPAN

Accepted
March 3, 1993

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