Abstract
We report the rare case of a patient of extrahepatic bile duct cancer with an aberrant common hepatic artery. A 69-year-old woman was admitted to our hospital with a history of epigastric pain and easy fatigability. Abdominal CT showed an enhancing mass in the distal bile duct. ERCP showed stenosis of the common bile duct, and exfoliative cytology revealed findings suggestive of an adenocarcinoma. 3D-CT angiography revealed an aberrant common hepatic artery which ran on the dorsal aspect of the inferior border of the pancreas, ascending on to the ventral surface of the pancreas head and continuing on to the proper hepatic artery. Subtotal stomach preserving pancreatoduodenectomy was performed with preservation of this aberrant common hepatic artery. Microscopic examination of the resected specimen showed a neuroendocrine tumor with concurrent tubular adenocarcinoma of the bile duct. Therefore, a final diagnosis of a mixed adenoneuroendocrine carcinoma was made on the basis of the 2010 WHO Classification of Tumors of the Digestive System. Adjuvant chemotherapy was administered with S-1, and the patient remains well without recurrence 10 months after the surgery.
