A CASE OF ENDOCRINE CELL CARCINOMA OF THE BILE DUCT WITH DISSEMINATED METASTASIS TO THE PTCD PATHWAY

Abstract

Billiary endocrine carcinomas are rare, especially endocrine cell carcinoma of the bile duct.
A 67-year-old man was admitted to the hospital because of obstructive jaundice. After a percutaneous transhepatic cholangiodrainage (PTCD), a pylorus preserving pancreatoduodenectomy was performed with a diagnosis of carcinoma of the lower bile duct. Histological exploration offered a diagnosis of endocrine cell carcinoma of the bike duct. One year and 9 months after operation, reoperation was performed for disseminated metastases to the liver and percutaneous area along the pathway of PTCD. Although usual endocrine cell carcinomas have poor prognosis, the patient has been recurrence free as of 2 years and 2 months after the reoperation, with a favorable clinical course. Further, disseminated metastasis after PTCD is rare, but some preventive stratedies for recurrence at the fistula as well as observation of clinical course by entertaining a possible disseminated metastasis along the pathway of PTCD are required, if a good prognosis can be expected for the original disease.