Wang Lili, Ma Xiaomei, Chen Dongdong, Ren Jialiang, Cheng Hua, Huang Gang, Wang Rong, Cheng Jiarong
Department of Radiology, Gansu Provincial Hospital, Lanzhou, China.
Department of Surgery, Gansu Provincial Hospital, Lanzhou, China.
J Int Med Res. 2020 Sep;48(9):300060520946871. doi: 10.1177/0300060520946871.
Cases of extrahepatic bile duct carcinoma are mostly adenocarcinomas and extrahepatic bile duct squamous cell carcinomas are rare. We report here a case of choledochal squamous cell carcinoma in a young woman who underwent surgery and chemotherapy. The woman presented with abdominal discomfort. A physical examination showed tenderness in the upper abdomen. Laboratory tests showed elevated direct bilirubin, total bilirubin, and C-reactive protein levels. Abdominal computed tomography and magnetic resonance imaging showed a cystic-solid mixed soft tissue mass in the common bile duct. Pain symptoms in the patient were not relieved and surgical treatment was performed. Postoperative pathological results showed a choledochal cyst complicated by squamous cell carcinoma. The patient was treated by biliary intestinal anastomosis followed by chemotherapy. However, the patient developed liver metastasis and recurrence at a 6-month follow-up. Primary congenital bile duct cysts with squamous cell carcinoma are extremely rare. Surgical resection is the main treatment option for choledochal squamous cell carcinoma. Postoperative chemoradiotherapy can be used, but the efficacy is poor and chemotherapy does not significantly prolong the patient's survival.
肝外胆管癌病例大多为腺癌，肝外胆管鳞状细胞癌罕见。我们在此报告一例年轻女性的胆总管鳞状细胞癌病例，该患者接受了手术和化疗。该女性表现为腹部不适。体格检查显示上腹部压痛。实验室检查显示直接胆红素、总胆红素和C反应蛋白水平升高。腹部计算机断层扫描和磁共振成像显示胆总管有一个囊实性混合软组织肿块。患者的疼痛症状未缓解，遂进行了手术治疗。术后病理结果显示胆总管囊肿合并鳞状细胞癌。患者接受了胆肠吻合术，随后进行化疗。然而，患者在6个月的随访中出现了肝转移和复发。原发性先天性胆管囊肿合并鳞状细胞癌极为罕见。手术切除是胆总管鳞状细胞癌的主要治疗选择。术后可采用放化疗，但疗效不佳，化疗并不能显著延长患者的生存期。
