2017 Volume 31 Issue 4 Pages 752-758
A 74-year-old woman presented to a neighborhood hospital with complains of upper abdominal pain. Since US examination revealed a strong echo sign in the common bile duct and dilatation of the common and intrahepatic bile duct, she was referred to our hospital for further evaluation and treatment. Contrast-enhanced CT showed two tumors in the lower bile duct. Endoscopic transpapillary biopsy was performed, and histpathological evaluation of the specimen revealed adenocarcinoma. Subtotal stomach-preserving pancreatoduodenectomy was performed under a diagnosis of lower bile duct cancer. Histopathologically both lesions were papillary adenocarcinomas with the invasion depth of fm and diagnosed with intraductal papillary neoplasms of the bile duct (IPNB) with an associated invasive carcinoma. Since there was no histological continuity between the two lesions, a diagnosis in this case was synchronous double cancer of IPNB with an associated invasive carcinoma in the extrahepatic bile duct.
