A case of metachronous biliary double cancer associated with superficially-spreading distal cholangiocarcinoma with intrahepatic tumor and gallbladder carcinoma

Abstract

A 65-year-old woman was performed cholecystectomy with regional lymph node dissection for gallbladder cancer (JSBS classification; well-differentiated tubular adenocarcinoma, pSS, pN0, M0, fStage II). One year after surgery, follow-up PET scan detected increased FDG uptake in the right liver. She was diagnosed as having superficially-spreading distal cholangiocarcinoma with hepatic metastasis by imaging examinations. Right hemihepatectomy with extrahepatic bile duct resection and reginal lymph node dissection was performed. Pathologically, the tumor spread superficially into the intrahepatic bile duct and formed a mass in the right liver. According to JSBS classification, the tumor was identified as papillaryadenocarcinoma, pT4 (Hinf3), pN0, M0, fStage IVa. This is a rare case of metachronous biliary double cancer associated with superficially-spreading distal cholangiocarcinoma with intrahepatic mass-formation and gallbladder carcinoma, but not associated with anomalous arrangement of the pancreaticobiliary ductal system.