Abstract
A 71-year-old man underwent surgery with a diagnosis of cancer of the pancreas head, T2N0M0 and Stage II. Upon laparotomy a 1-cm diameter circular white nodule was found at the segment IV/V of the liver. Partial hepatectomy was performed and intraoperative frozen section diagnosis was reported to be high or moderately differentiated adenocarcinoma. According to the therapeutic guidelines, pancreas cancer with distant metastasis is not a candidate for operation and is indicated chemotherapy or best supportive care. In this case, however, preoperative imaging methods did not provide any suspicion of hepatic metastasis, and the possibility of hepatic metastasis should not be high in terms of the progression of the primary foci. Accordingly we determined that the cancer nest should be resected without leaving cancer remnant, and performed pancreaticoduodenectomy with D2 dissection. The resected hepatic tumor was diagnosed as intrahepatic bile duct adenoma on the permanent preparation.
Intrahepatic bile duct adenoma is a rare benign hepatic tumor. It is incidentally detected at surgical resection in many cases and the tumor resembles metastatic hepatic cancer, so that attention must be paid when the disease is associated with a malignant tumor. This paper deals with a case of intrahepatic bile duct adenoma associated with pancreas head cancer.
