早期胆嚢・胆管癌の同時性重複癌の１例

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  • A Case of Synchronous Double Cancer Involving Early Gallbaladder Cancer and Bile Duct Cancer.

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We report a case of synchronous double cancer, early gallbladder cancer and bile duct cancer, which is very rare. A 78-year-old man was seen at the department of internal medicine in our hospital because of epigastralgia. Abdominal CT scan visualized thickening of the gallbladder wall from the neck to body. And the common bile duct dilated to 18mm in diameter, but there were no stones. No pancreatic tumor nor lymph node swelling was also present. Endoscopic retrograde cholangio pancreatography revealed the dilated common bile duct and a filling defect 14mm in diameter in the common hepatic duct. EUS showed a localized thickening of epithelium of the gallbladder. A diagnosis of gallbladder and common hepatic duct tumors was made, and the patient was referred to the department. Under the diagnosis, a laparotomy was performed. Although gallbladder tumor was obscure, a nodular lesion 10mm in diameter was present in the common hepatic duct and it was diagnosed as bile duct cancer. A resection of the extrahepatic bile duct and an anastomosis of the common hepatic duct to jejunum were performed. Histopathological diagnosis was upper bile duct cancer and gallbladder cancer with tumor invasion of mucosa, without lymph nodes metastasis and vascular infiltration.

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