A CASE OF BILE DUCT CANCER WITH LONG-TERM SURVIVAL AFTER OPERATION IN SPITE OF RESIDUAL CANCER AT THE RESECTED MARGIN

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  • 切除断端陽性で長期生存した胆管癌の1例

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Abstract

We have encountered a case of slow growing bile duct cancer with eleven years survival after operation inspite of residual cancer at the resected margin.<br> A 53-year-old woman with a previous history of bile duct resection for upper and middle bile duct cancer was absolute noncurative resection for residual cancer at the bilateral resected margin. After eleven years, the level of CA19-9 increased, and abdominal CT scanning revealed a tumor 1.5cm at the pancreas head. Endoscopic retrograde cholangiopancreatography showed a papillomatous tumor of the papilla of Vater, thus, a pancreatoduodenectomy was performed. Surgical findings revealed invasional growth from the resected margin of residual cancer to the papilla of Vater. Histologically, the tumor proved to be recurrent moderately differentiated adenocarcinoma. Growth of the residual cancer at the resected margin was considered. DNA ploidy pattern, which is regarded as a valuable parameter of malignancy of bile duct cancer, showed a DNA aneuploidy pattern.

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