Multiple tumors of the biliary tract

Gertsch, Philippe; Thomas, Philip; Baer, H. U.; Lerut, Jan; Zimmermann, Arthur; Blumgart, Leslie H.

doi:10.1016/s0002-9610(05)81278-4

Cited by 59 publications

(49 citation statements)

References 9 publications

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“…Most are found on removing the gallbladder during a resection for bile duct cancer [4][5][6] . However, metachronous multiple bile duct cancer is very rare.…”

Section: Discussionmentioning

confidence: 99%

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Metachronous bile duct cancer nine years after resection of gallbladder cancer

Joo

Kim²,

Jeon³

et al. 2009

WJG

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We report a rare case of a 74-year-old man with metachronous gallbladder cancer and bile duct cancer who underwent curative resection twice, with the operations nine years apart. At the age of 65 years, the patient underwent a cholecystectomy and resection of the liver bed for gallbladder cancer. This was a welldifferentiated adenocarcinoma, with negative resection margins ( T2N0M0, stage ⅠB). Nine years later, during a follow-up examination, abdominal computed tomography and MRCP showed an enhanced 1.7 cm mass in the hilum that extended to the second branch of the right intrahepatic bile duct. We diagnosed this lesion as a perihilar bile duct cancer, Bismuth type Ⅲ a, and performed bile duct excision, right hepatic lobectomy and Roux-en-Y hepaticojejunostomy. The histological diagnosis was a well-differentiated adenocarcinoma with one regional lymph node metastasis (T1N1M0, stage ⅡB). Twelve months after the second operation, the patient is well, with no signs of recurrence. This case is compared with 11 other cases of metachronous biliary tract cancer published in the world medical literature.

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“…Most are found on removing the gallbladder during a resection for bile duct cancer [4][5][6] . However, metachronous multiple bile duct cancer is very rare.…”

Section: Discussionmentioning

confidence: 99%

“…Synchronous multiple biliary cancers occur in 3.7%-7.4% of all surgically resected biliary tumors. Most of them develop in the gallbladder and bile duct [4][5][6] . On the other hand, metachronous multiple biliary cancers are rare, with only 11 cases reported in the world literature [7][8][9][10][11][12][13][14][15][16][17] .…”

Section: Introductionmentioning

confidence: 99%

Metachronous bile duct cancer nine years after resection of gallbladder cancer

Joo

Kim²,

Jeon³

et al. 2009

WJG

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“…Generally, gallbladder carcinoma is called unsuspected gallbladder carcinoma (UGC) when it was found incidentally during or after cholecystectomy because of gallbladder benign diseases [7,8,10,11] . We consider that UGC still includes gallbladder carcinoma found not only during or after cholecystectomy but also in the course of other diseases [12][13][14][15][16][17] . UGC found during cholecystectomy because of acute or chronic cholecystitis was reported in 1961 [18] , but more relative studies and close attention to UGC became available in the 1990s.…”

Section: Introductionmentioning

confidence: 99%

A clinicopathological analysis in unsuspected gallbladder carcinoma: A report of 23 cases

Zou²

2007

WJG

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AIM:To study the clinicopathological characteristics of unsuspected gallbladder carcinoma (UGC). METHODS:We retrospectively studied 23 cases of UGC in Tongji Hospital, and compared their clinicopathological characteristics with 33 cases of preoperatively diagnosed gallbladder carcinoma (PDGC). RESULTS:The proportion of UGC coexisting with cholecystolithiasis was significantly higher than that of PDGC (χ 2 = 13.53, P < 0.01). The infection rate of hepatitis B virus was 21.74% (5/23) in UGC and 30.30% (10/33) in PDGC. Nine (39.13%) of 23 patients with UGC and 8/33 (24.24) PDGC had contact with schistosome pestilent water. The rate of multiple pregnancies was 56.52% (13/23) in the patients with UGC and 42.42% (14/33) in PDGC. The primary location of the UGC was mostly in the neck and body of the gallbladder, and that of the PDGC was often in the body and bottom. The incidence of Nevin stageⅠand Ⅱ UGC was significantly higher than that of PDGC (χ 2 = 4.44, P < 0.05 and χ 2 = 4.96, P < 0.05) while that of Nevin stage Ⅴ UGC was significantly lower than that of PDGC (χ 2 = 7.59, P < 0.01).According to the grading of carcinoma, the incidence of well-differentiated UGC was significantly higher than that of PDGC (χ 2 = 4.16, P < 0.05), and that of poorlydifferentiated UGC was significantly lower than that of PDGC (χ 2 = 4.48, P < 0.05). CONCLUSION:There are different characteristics between UGC and PDGC, such as in primary location, malignant degree and incidence of coexistence with cholecystolithiasis. Cholecystolithiasis, hepatitis B, schistosome and multiple pregnancies were high risk factors for gallbladder carcinoma.

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“…Although the histologic and clinicopathologic features of those biliary papillary neoplasms that clinicopathologically resemble pancreatic IPMNs have been described in clinical case reports and several series (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(22)(23)(24)(25), their genetic alterations have only rarely been investigated (11,20). One case of biliary papillomatosis was shown to carry an activating mutation of the K-ras oncogene (11), but we recently found only relatively infrequent K-ras mutations, relatively infrequent allelic losses on chromosomes 5q and 18q, and no evidence for p53/ chromosome 17p alterations in biliary IPNs (20).…”

Section: Discussionmentioning

confidence: 99%

Microsatellite Instability in Intraductal Papillary Neoplasms of the Biliary Tract

et al. 2002

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Intraductal papillary neoplasms of the biliary tree are unusual lesions characterized by solitary or diffuse growth along the intra-and/or extrahepatic biliary tract. Biliary papillary neoplasms bear some clinicopathologic similarity to intraductal papillary mucinous neoplasms of the pancreas. Like intraductal papillary mucinous neoplasms of the pancreas, biliary papillary neoplasms can be purely intraductal lesions or can give rise to invasive adenocarcinomas. We recently studied the genetic alterations present in a series of biliary papillary neoplasms and noted the presence of allelic shifts in some biliary tumors during allelic loss assays on chromosomes 5q and 18q. This suggested that microsatellite instability might play a role in the molecular pathogenesis of biliary papillary neoplasms. Genomic DNA was extracted from 17 intraductal papillary neoplasms, 6 associated invasive cholangiocarcinomas, and corresponding normal tissues, and microsatellite instability testing was performed using the 5 microsatellite loci recommended by the 1997 National Cancer Institute-sponsored consensus conference (D2S123, D5S346, D17S250, Bat-25, and Bat-26). High-level microsatellite instability was considered to be present when at least two of five microsatellite loci showed allelic shifts, and low-level microsatellite instability, when only one locus was shifted, as per the National Cancer Institute criteria. We also determined the methylation status of the DNA mismatch repair gene hMLH1 by bisulfite treatment of genomic DNA, followed by methylation-specific PCR. High-level microsatellite instability was present in 2 of 17 (11.8%) biliary papillary neoplasms, including 1 case of purely intraductal tumor and 1 case with both intraductal and invasive cholangiocarcinoma components. In both cases there was extensive microsatellite instability, with allelic shifts in five of five and four of five microsatellite markers, respectively. Low-level microsatellite instability was present in 6 of 17 (35.3%) biliary papillary neoplasms, including 2 cases of purely intraductal tumor and 4 cases with both intraductal and invasive cholangiocarcinoma components. Interestingly, the pattern of allelic shifts was frequently not identical between the intraductal and invasive cholangiocarcinoma components; although the same microsatellite markers were shifted, alleles of differing lengths were generated in the intraductal and invasive components of the neoplasms with high-level microsatellite instability and of two neoplasms with low-level microsatellite instability. None of the biliary papillary neoplasms (0 of 10 cases with adequate DNA for evaluation) showed methylation of hMLH1. These results indicate that microsatellite instability is a relatively frequent event in papillary neoplasms of the biliary tree but is not associated with hMLH1 promoter hypermethylation. The finding that alleles of differing lengths were frequently generated between the intraductal and invasive components of those tumors with microsatellite instability suggests tha...

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Multiple tumors of the biliary tract

Cited by 59 publications

References 9 publications

Metachronous bile duct cancer nine years after resection of gallbladder cancer

Metachronous bile duct cancer nine years after resection of gallbladder cancer

A clinicopathological analysis in unsuspected gallbladder carcinoma: A report of 23 cases

Microsatellite Instability in Intraductal Papillary Neoplasms of the Biliary Tract

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