-Case Reports-

A Case of Extrahepatic Bile Duct Wall Recurrence of Gastric Carcinoma that Was Treated with Pancreaticoduodenectomy

Takashi Shirakawa^1,2, Kimiyoshi Yokoi^1,2, Tomoko Seya^1,2, Masato Yoshioka^1,2, Yoshiharu Ohaki³ and Eiji Uchida¹

¹Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
²Department of Surgery, Nippon Medical School Chiba Hokusoh Hospital
³Institute of Pathology, Nippon Medical School Chiba Hokusoh Hospital

We report on a patient with obstructive jaundice caused by recurrence of gastric carcinoma in the wall of an extrahepatic bile duct more than 5 years after gastrectomy who was treated with pancreaticoduodenectomy. Histopathologic examination of the surgically resected specimen revealed a poorly differentiated adenocarcinoma with focal signet ring cells in the wall of the common bile duct which was histologically similar to the primary gastric carcinoma. To confirm the diagnosis, immunohistochemical staining was performed with antibodies against cytokeratins (CK7, CK20) and mucin peptide core antigens (MUC5AC, MUC6, MUC2). Based on the expression patterns of this monoclonal antibody panel, the final diagnosis of the common bile duct tumor was an isolated local recurrence of the gastric carcinoma. The patient has survived for more than 26 months after pancreaticoduodenectomy without recurrence.

J Nippon Med Sch 2010; 77: 170-174

Keywords
obstructive jaundice, pancreaticoduodenectomy, recurrent gastric carcinoma

Correspondence to
Takashi Shirakawa, MD, Department of Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba 270-1694, Japan
stakashi@nms.ac.jp

Received, December 10, 2009
Accepted, January 20, 2010