2016 Volume 30 Issue 4 Pages 769-774
We report three patients with solid adenocarcinoma of the bile duct, which is characterized as an expansive tumor growth and solid proliferation. Two of the three underwent pancreatoduodenectomy with portal vein resection under a diagnosis of distal cholangiocarcinoma; the remaining one underwent left hepatic trisectionectomy with portal vein resection under a diagnosis of perihilar cholangiocarcinoma. Macroscopically, all three patients had a tumor mass with extramural growth measuring 1.6 to 3.6cm in diameter; microscopically, the large-sized cancer cells showed solid or sheet-like proliferation, making the final diagnosis of solid adenocarcinoma of the bile duct. Ki-67 labeling index was high, ranging from 20 to 80%. In spite of the expansive configuration, all tumors extensively invaded the major vessels as well as the adjacent organs, suggesting a locally aggressive nature of this rare histologic type. Unfortunately, one patient with positive radial margin died of local relapse 4 months after surgery; the remaining two patients have been alive without disease, 1 and 4 years after surgery, respectively. These findings suggest that extended surgical procedures including vascular resection are often required and that tumor-free margin is important for prolonged survival in patients with solid adenocarcinoma of the bile duct.
