A case of bile duct carcinoma associated with superficial spreading

Abstract

A case of bile duct carcinoma associated with superficial spreading is reported. A-77-year old woman was admitted to our hospital because of jaundice and upper abdominal pain. Abdominal ultrasonography revealed swelling of the gallbladder and dilatation of the intrahepatic duct. The cholangiography via PTBD revealed the defect of about 3 cm indiameter at the middle bile duct. Irregularity of the bile duct was recognized at the hepatic side from defect. PTCS revealed granular mucosa at the hepatic side from papillary tumor. Under the diagnosis of bile duct carcinoma associated with superficial spreading, pylorus preserving pancreatoduodenectomy was performed. Microscopically papillary, adenocarcinoma invaded to fibromuscular layer at the middle bile duct. The extension of the superficial spread of cancer was almost same at the preoperative estimation.