A Case of Cancer of the Gallbladder Diagnosed on the Onset of Biliary Ascariasis

Eriko Umeda, Shunichi Shiozawa, Kenichi Kumazawa, Toshio Masuda, Arihiro Umehara, Hiroyuki Kato, Shunsuke Haga and Tetsuro Kajiwara

Department of Surgery, Tokyo Women's Medical University Daini Hospital

A 72-year-old woman was referred to our department with a complaint of repetitive upper abdominal pain. Abdominal ultrasonography and contrast-enhanced computed tomography (CT) revealed a lobulated elevated lesion of about 2 cm in size with an irregular border in the neck of the gallbladder. On endoscopic retrograde cholangiopancreatography (ERCP), a moving hypertranslucent image was depicted in the common bile duct in the shape of a cord. An aberrant parasite of the bile duct and gallbladder cancer were diagnosed, and extraction of the parasite, cholecystectomy, and resection of the biliary tract and the hepatic floor were performed. The tumor was histopathologically diagnosed as papillary adenocarcinoma with a depth of invasion of ss, hinf₀,binf₀,n₀,stage II, and a curability of A. The parasite was found to be a female ascarid of about 15 cm long. Since the patient did not have any biliary calculus, the initial symptom of the upper abdominal pain was believed to be attributable to the ascarid which had migrated into the bile duct. This is a unique case in which a concomitant gallbladder cancer was detected at a relatively early stage because of the presence of ascarids.

Key words
cancer of the gallbladder, biliary ascariasis

Reprint requests
Eriko Umeda Department of Surgery, Tokyo Women's Medical University Daini Hospital 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567 JAPAN

Accepted
April 28, 1999

To read the PDF file you will need Abobe Reader installed on your computer.