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2015, Number 3

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Ann Hepatol 2015; 14 (3)

Papillary in situ and intramucosal adenocarcinoma of the lower third of common bile duct. A report and review of the literature

Montalvo-Javé EE, Chablé-Montero F, Toapanta-Yanchapaxi LN, Rojas-Mendoza F, López-Caballero C, Roca-Cabrera ML, Mendoza-Barrrera GE

Language: Spanish
References: 26
Page: 425-429
PDF size: 210.67 Kb.


ABSTRACT

We report the case of a 37-year-old woman with no relevant medical history. She was admitted to the hospital for epigastric pain related with food intake for 4 days; the pain did not improve with symptomatic management. A laparoscopic cholecystectomy due to acute lithiasic cholecystitis was performed. However, after 4 days, postoperative painless jaundice was evident; thus, endoscopic retrograde cholangiopancreatography was performed, which revealed an amputation of intrapancreatic common bile duct, as well as secondary intra- and extrahepatic bile duct dilatation. Brushing of the distal portion of the common bile duct revealed a well-differentiated adenocarcinoma. Therefore, a Whipple procedure with pylorus preservation was performed. Pathologic diagnosis of a papillary in situ adenocarcinoma with two microscopic foci of microinvasion was established. The pathologic Tumor-Node-Metastasis (TNM) stage was pT1, pN0, pM0, R0. The patient is asymptomatic and disease-free 24 months after surgery. In general, adenocarcinomas of the extrahepatic bile ducts are uncommon and have a poor prognosis. However, symptomatic patients with early disease stages are even rarer and can be cured surgically.


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