総胆管原発の腺内分泌細胞癌の1例

  • 新地 洋之
    鹿児島大学大学院医歯学総合研究科先進治療科学専攻腫瘍学講座腫瘍制御学・肝胆膵外科学
  • 高尾 尊身
    鹿児島大学大学院医歯学総合研究科先進治療科学専攻腫瘍学講座腫瘍制御学・肝胆膵外科学 鹿児島大学生命科学資源開発センター
  • 前村 公成
    鹿児島大学大学院医歯学総合研究科先進治療科学専攻腫瘍学講座腫瘍制御学・肝胆膵外科学
  • 瀧川 譲治
    鹿児島大学大学院医歯学総合研究科先進治療科学専攻腫瘍学講座腫瘍制御学・肝胆膵外科学
  • 大井 恭代
    鹿児島大学大学院医歯学総合研究科先進治療科学専攻腫瘍学講座腫瘍制御学・腫瘍病態学
  • 愛甲 孝
    鹿児島大学大学院医歯学総合研究科先進治療科学専攻腫瘍学講座腫瘍制御学・肝胆膵外科学

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  • A Case of Adenoendocrine Cell Carcinoma of the Extrahepatic Bile Duct

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We report a case of adenoendocrine cell carcinoma of the extrahepatic bile duct. A 73-year-old man with up per abdominal pain was found in endoscopic retrograde cholangiopancreatography (ERCP) and magnetic reso nance cholangiopancreatography (MRCP) to have a 3×3cm polypoid mass at the upper common bile duct. Under a diagnosis of papillary cancer, we resected the extrahepatic bile duct with regional lymph node dissecti on. Histopathologically, the tumor consisted of solid nests of atypical argyrophilic cells, with well differenti ated tubular adenocarcinoma replacing mucosa. Immunohistochemical analysis showed positive staining for chromogranin A. The definitive diagnosis was adenoendocrine cell carcinoma of the common bile duct. Ade noendocrine cell carcinoma of the common bile duct is rare and only 17 cases, including ours, have been re ported 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.

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