Carcinoma of the lower end of the common bile-duct

Carcinoma of bile ducts in husband and wife.

“…No clues to the aetiology of bile duct tumour are available from the literature, although theories abound and include the following: carcinogenic action of cholic acid (Dick, 1939) or its conversion to methylcholanthrene (Glenn and Hill, 1955); precancerous inflammatory proliferation of the ductal accessory glands (Hess and Werthemann, 1957); carcinoma originating from previous ulceration of the bile ducts (Rolleston and McNee, 1929); malignant change in a benign papilloma (Dick, 1939); preexisting cholelithiasis (Illingworth, 1935); Giardia lamblia infestations (Grott, cited by Brown, Strang, Gordon, and Hendry 1961); radioactive salts in gallstones (Lazarus-Barlow, 1918); embryonic rests (Illingworth, 1945). Recently it has been suggested that aflatoxin may play a role in the aetiolovgy of liver tumours in animals (Butler and Barnes, 1963;Carnaghan, 1965;and Ashley, Halver, Gardner, and Wogan 1965) but no evidence as to its toxicity in man has been put forward (Allcroft and Carnaghan, 1963).…”