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Metachronous Carcinomas of the Biliary Tract in a Patient Treated Three Times with Curative Surgery.
[carcinoma of the gallbladder]
We
here
report
on
a
case
of
metachronous
multicentric
carcinomas
of
the
biliary
tract
treated
3
times
with
curative
surgery
over
23
years
.
A
28
-
year
-old
woman
underwent
cholecystectomy
because
of
papillary
carcinoma
of
the
gallbladder
.
After
17
years
,
3
carcinomas
developed
in
the
biliary
tract
:
intrahepatic
cholangiocarcinoma
of
the
left
liver
,
common
bile
duct
carcinoma
,
and
remnant
cystic
duct
carcinoma
.
They
were
successfully
removed
via
left
hepatectomy
combined
with
pylorus-preserving
pancreatoduodenectomy
.
Furthermore
,
another
intrahepatic
cholangiocarcinoma
developed
6
years
after
the
second
surgery
,
which
was
removed
again
via
partial
resection
of
the
posterior
segment
of
the
liver
.
Histological
findings
of
carcinomas
represented
various
grades
of
cell
differentiation
.
No
predisposition
toward
carcinogenesis
was
found
,
since
neither
pancreaticobiliary
maljunction
nor
primary
sclerosing
cholangitis
was
present
,
and
the
overexpression
of
cyclooxygenase-
2
was
negative
in
all
resected
specimens
.
Close
monitoring
for
recurrence
is
warranted
for
early
detection
of
metachronous
carcinoma
that
might
be
effectively
treated
with
repeated
resection
.
