Kobayashi Kenta, Ito Takashi, Tomii Shohei, Oda Toyoshi, Enjoji Megumu
Dept. of Surgery, JA Toride Medical Center.
Gan To Kagaku Ryoho. 2022 Dec;49(13):1541-1543.
An 82-year-old male with jaundice was referred to our hospital for a detailed examination. The computed tomography (CT) examination detected an enhanced mass lesion of the distal bile duct. Endoscopic retrograde cholangiography showed a filling defect corresponding to the CT findings. Simultaneously, a forceps biopsy and an endoscopic retrograde biliary drainage were performed. We performed pancreatoduodenectomy, and adenocarcinoma was pathologically proven. The histopathological finding of the resected specimen was a mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) composed of large cell neuroendocrine carcinoma and well-differentiated adenocarcinoma. Although pathological R0 resection was achieved, liver metastasis was observed 6 months after the operation. Although neuroendocrine carcinoma (NEC) rarely develops in the bile duct, it manifests a higher degree of malignancy than other ordinary bile duct adenocarcinomas. Further investigation is needed to choose an appropriate treatment.
一名82岁的黄疸男性被转诊至我院进行详细检查。计算机断层扫描（CT）检查发现远端胆管有强化肿块病变。内镜逆行胆管造影显示与CT结果相符的充盈缺损。同时，进行了钳取活检和内镜逆行胆管引流。我们实施了胰十二指肠切除术，病理证实为腺癌。切除标本的组织病理学发现是一种由大细胞神经内分泌癌和高分化腺癌组成的混合性神经内分泌-非神经内分泌肿瘤（MiNEN）。尽管实现了病理R0切除，但术后6个月观察到肝转移。虽然神经内分泌癌（NEC）很少在胆管中发生，但其恶性程度高于其他普通胆管腺癌。需要进一步研究以选择合适的治疗方法。
