2018 Volume 51 Issue 10 Pages 622-630
An 85-year-old woman was given a diagnosis of papillary adenocarcinoma of the gallbladder, pT2N1M0, stage II. She underwent S4a/S5 hepatectomy with D2 lymph node dissection. Eighteen months later, papillary lesions were detected in the common bile duct on CT scan, and biopsy indicated the recurrence of gallbladder carcinoma because of the pathological similarity. On the basis of these findings, the patient underwent pylorus-preserving pancreaticoduodenectomy with D2 lymph node dissection. Histopathological examination showed multiple tumors in the common bile duct interspersed with normal mucosa. These tumors were diagnosed as synchronous and multifocal cholangiocarcinoma, papillary adenocarcinomas, pT1N0M0, stage IA. Synchronous multiple tumors occurring in the extrahepatic bile duct are rare, but the possibility should be considered before and during surgery to formulating a treatment strategy.
