A Case of Preoperatively Diagnosed Extrahepatic Bile Duct Metastasis of Colorectal Carcinoma

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  • 術前に診断した大腸癌肝外胆管転移の1例
  • 症例 術前に診断した大腸癌肝外胆管転移の1例
  • ショウレイ ジュツゼン ニ シンダン シタ ダイチョウ ガン カン ガイタンカン テンイ ノ 1レイ

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<p>A 73-year-old man had undergone sigmoid colectomy for sigmoid colon carcinoma in November 2015 that was pathologically diagnosed as pT3N0M0, p Stage II. Asynchronous hepatic metastasis was identified in February 2017, and extended posterior segmentectomy and partial hepatectomy of six areas of the liver were performed in May that year. Pathological tests confirmed that the tumors were hepatic metastases of the sigmoid colon carcinoma, and histological bile duct invasion was evident around the metastatic sites. In November 2017, carcinoembryonic antigen was elevated, and contrast-enhanced computed tomography showed a 14-mm nodular shadow in the common bile duct at the union of the cystic and common hepatic ducts. Endoscopic retrograde cholangiopancreatography and intraductal ultrasound showed that the tumor had grown into the lumen of the bile duct from its wall. The results of immunohistological staining on bile duct smear cytology were CK7(-), CK20(+), and CDX2(+), confirming that the tumor was a bile duct metastasis of the sigmoid colon carcinoma, and extrahepatic bile duct resection and choledochojejunostomy were performed. The resected specimen contained a mass located in the bile duct wall that projected into the lumen, and since the results of both hematoxylin-eosin staining and immunostaining were similar to those of the primary tumor and the hepatic metastases, extrahepatic duct metastasis of colorectal cancer was diagnosed.</p>

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