A Case of Small Cell Carcinoma of the Extrahepatic Bile Duct -A Review of 11 Cases-

Hideki Yamada, Michio Kanai, Yoriyuki Nakamura, Yasuhiro Ohba, Katsura Hamaguchi, Shunichiro Komatsu, Jyunji Washizu, Shinsuke Kiriyama, Takashi Yano and Hiroshi Sugiura*

Department of Surgery and Pathology*, Kasugai Municipal Hospital

We report a case of small cell carcinoma of the extrahepatic bile duct. A 80-year-old man admitted for appetite loss was found in CT to have a dilated intrahepatic bile duct and a slightly high-density mass at the middle of the extrahepatic bile duct. On endoscopic retrograde cholangiopancreatography (ERCP), magnetic resonance cholangiopancreatography (MRCP) and cholangiography via percutaneous transhepatic biliary drainage (PTBD), we found a round tumor at the middle of the extrahepatic bile duct, and biopsy showed poorly differenciated adenocarcinoma. Cholangioscopically, superficial spread of the cancer was not detected. Under a diagnosis of papillary middle bile duct cancer, we resected the common bile duct. Microscopic examination of the tumor showed small cell carcinoma (pure type) by HE staining and immunological staining with chromogrannine A. Superficial spread of the tumor was not detected at the common bile duct. The postoperative course was favorable, and the patient was discharged on postoperative day 19.
Only 11 cases of small cell carcinoma of the bile duct, including our case, have, to our knowledge, been reported. Papillary bile duct cancer with a preoperative diagnosis of poorly differentiated adenocarcinoma, we should suspect a tumor of small cell carcinoma of the bile duct.

Key words
small cell carcinoma, papillary type, middle bile duct

Reprint requests
Hideki Yamada Department of Surgery, Kasugai Municipal Hospital
1-1-1 Takagi-cho, Kasugai-shi, 486-8510 JAPAN

Accepted
July 23, 2003

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