壊疽性胆嚢炎で発症した胆嚢管癌の1例 A CASE OF CYSTIC DUCT CANCER CAUSED BY GANGRENOUS CHOLECYSTITIS

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胆嚢管癌は稀な疾患であり,術前に正診することは困難である.今回われわれは,術後病理組織検査にて診断された胆嚢管癌の1例を経験したので報告する.症例は83歳,男性.腹痛を主訴に近医を受診後,胆嚢炎を疑われ当科紹介入院.胆石症,壊疽性胆嚢炎の診断にて同日緊急手術を施行した.開腹時,胆嚢壁は体部から底部にかけて壊死性変化を認めた.術中胆道造影では,悪性を示唆する所見は認められなかった.術後病理組織検査にて,胆嚢管に限局性に乳頭状構造を呈する上皮の増殖像を認め,乳頭状腺癌と診断された.追加手術の適応と考えられたが,高齢でかつ本人の同意なかったため外来経過観察とした.現在術後10カ月経過し,無再発生存中である.

Cystic duct cancer, which is relatively rare, has been difficult to correctly diagnose preoperatively. We report a cystic duct cancer case detected incidentally in a preoperative histopathologic examination and discuss findings from the literature. An 83-year-old man with abdominal pain was hospitalized with suspected cholecystitis. Under a diagnosis of cholelithiasis and gangrenous cholecystitis determined by a series of examinations, he underwent emergency surgery. Intraoperative findings showed necrosis from the body to the fundus of the gallbladder wall. Since no intraoperative finding suggested malignancy, we conducted standard cholecystectomy following intraoperative cholangiography. Postoperative histopathologic examinations showed an epidermal growth with a papillary structure localized in the cystic duct, so the case diagnosis was papillary adenocarcinoma. We advised the patient to undergo additional surgery, but he refused by reason of age, so we decided to follow up on his condition. In the ten months since surgery, he remains alive and has shown no signs of recurrence.

収録刊行物

  • 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 65(3), 771-775, 2004-03-25

    Japan Surgical Association

参考文献:  16件中 1-16件 を表示

被引用文献:  2件中 1-2件 を表示

各種コード

  • NII論文ID(NAID)
    10012865503
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    13452843
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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