Department of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine Niigata University Hospital, Japan.
Division of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, Japan.
Intern Med. 2020 Sep 1;59(17):2129-2134. doi: 10.2169/internalmedicine.4613-20. Epub 2020 Jun 2.
A 69-year-old man was referred to our hospital because of appetite loss. Imaging showed a nodular tumor in the perihilar bile duct and a second flat lesion in the distal bile duct. Right hepatopancreaticoduodenectomy was performed, and the histopathological findings demonstrated that the perihilar and distal lesions were moderately and poorly differentiated adenocarcinoma, respectively, and anatomically separated. Furthermore, the resected specimens showed no pancreaticobiliary maljunction. Histological and TP53 gene analyses in a rare case of synchronous double bile duct cancers suggest that there are various genetic pathways through which bile duct cancer develops, highlighting the complexity of its pathogenesis.
一位 69 岁男性因食欲减退到我院就诊。影像学检查显示肝门周围胆管有结节状肿瘤，远端胆管有第二个扁平病灶。行右肝胰十二指肠切除术，组织病理学检查结果显示肝门周围和远端病变分别为中分化和低分化腺癌，且解剖上是分开的。此外，切除标本无胰胆管合流异常。同步双胆管癌的罕见病例的组织学和 TP53 基因分析表明，胆管癌的发生存在多种遗传途径，突显了其发病机制的复杂性。
