The Simultaneous Triple Cancers in the Bile Ducts Accompanied with Congenital Biliary Dilatation

Seizo Masutani, Osamu Ishikawa, Shingi Imaoka, Hiroaki Ohigashi, Masao Kameyama, Yo Sasaki, Toshiyuki Kabuto, Hiroshi Furukawa, Hiroki Koyama, Takeshi Iwanaga

The Department of Surgery, The Center for Adult Diseases, Osaka

We present the first case triple cancers in the bile ducts of congenital biliary dilatation (CBD). The patient was a 38-year-old woman with chief complaints of right hypochondralgia and appetite loss. At 8 years of age, surgery had been recommended to her because of the complication of CBD. Preoperative radiologic images showed dilatation of the common bile duct, the tumor in the dilated left intra-hepatic duct and anomalous arrangement of the pancreatico-biliary ducts. The second cancer was found in the bile duct of the pancreas during surgery, but the third cancer, existing as occult cancer, was detected in the gallbladder by postoperative histologic examination. We performed left lobectomy of the liver and pancreatoduodenectomy. The histologic findings of the tumor in the left intrahepatic duct, gallbladder and pancreas were so-called carcinosarcoma, well differentiated adenocarcinoma and moderately differentiated adenocarcinoma, respectively. Triple cancers in the bile duct or double cancers of the intrahepatic duct and in pancreas with CBD have not been previously reported in the world literature.

Key words
congenital biliary dilatation, simultaneous triple cancers of the bile duct, anomalous arrangement of pancreato-biliary ducts

Reprint requests
Seizo Masutani The Department of Surgery, The Cancer for Adult Diseases, Osaka
1-3-3 Nakamichi Higashinari-ku, Osaka, 537 JAPAN

Accepted
June 14, 1993

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