A Case of Adenoendocrine Cell Carcinoma of the Extrahepatic Bile Duct

Hiroyuki Shinchi¹⁾, Sonshin Takao^{1) 3)}, Kosei Maemura¹⁾, Joji Takigawa¹⁾, Yasuyo Ohi²⁾ and Takashi Aikou¹⁾

Department of Surgical Oncology and Hepato-Biliary-Pancreatic Surgery, Field of Oncology, Course of Advanced Therapeutics¹⁾
Department of Tumor Pathology²⁾, Kagoshima University Graduate School of Medical and Dental Sciences, Research Center for Life Science Resources³⁾, Kagoshima University

We report a case of adenoendocrine cell carcinoma of the extrahepatic bile duct. A 73-year-old man with upper abdominal pain was found in endoscopic retrograde cholangiopancreatography (ERCP) and magnetic resonance cholangiopancreatography (MRCP) to have a 3× 3 cm polypoid mass at the upper common bile duct. Under a diagnosis of papillary cancer, we resected the extrahepatic bile duct with regional lymph node dissection. Histopathologically, the tumor consisted of solid nests of atypical argyrophilic cells, with well differentiated tubular adenocarcinoma replacing mucosa. Immunohistochemical analysis showed positive staining for chromogranin A. The definitive diagnosis was adenoendocrine cell carcinoma of the common bile duct. Adenoendocrine cell carcinoma of the common bile duct is rare and only 17 cases, including ours, have been reported in the literature. Adenoendocrine cell carcinoma may involve high-grade malignancy and a dismal prognosis. Our patient died of multiple liver metastasis 4 months after surgery. Multidisciplinary treatment is thus recommended for treating adenoendocrine cell carcinoma of the bile duct.

Key words
adenoendocrine cell carcinoma, small cell carcinoma, common bile duct

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Hiroyuki Shinchi Department of Surgical Oncology and Hepato-Biliary-Pancreatic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences
8-35-1 Sakuragaoka, Kagoshima, 890-8520 JAPAN

Accepted
September 22, 2004

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