Korean J Gastrointest Endosc > Volume 31(6); 2005 > Article
Korean Journal of Gastrointestinal Endoscopy 2005;31(6): 437-442.
Klatskin암과 유두부암의 동시성 중복암 1예
이범재·이홍식·현종진·김경진·김민정·정록선·김용식·임형준·진윤태 전훈재·엄순호·이상우·최재현·김창덕·류호상·현진해
고려대학교 의과대학 내과학교실 소화기연구소
A Case of Synchronous Double Cancer -Klatskin's Tumor and Ampullary Adenocarcinoma-
Beom Jae Lee, M.D., Hong Sik Lee, M.D., Jong Jin Hyun, M.D., Kyung Jin Kim, M.D., Min Jeong Kim, M.D., Rok Son Choung, M.D., Yong Sik Kim, M.D., Hyung Jun Lim, M.D., Yoon Tae Jeen, M.D., Hoon Jai Chun, M.D., Soon Ho Um, M.D., Sang Woo Lee, M.D., Jai Hyun
Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Ansan, Korea
Abstract
Multiple cancers in the extrahepatic biliary tree are relatively rare. Many such cases are a double cancer of the common bile duct and the gallbladder. We report a case of a double primary cancer that occurred synchronously at the hilum of the extrahepatic duct and the ampulla of Vater with a review of the relevant literature. A 57-year-old man was admitted to our institution after a 15 day of painless jaundice and a urine color change. Ultrasonography showed a dilation of both intrahepatic ducts. Upper endoscopy revealed a protruding ulcerative mass at the ampulla of Vater and endoscopic retrograde cholangiography showed a dilated common bile duct and a mildly dilatated pancreatic duct, but both intrahepatic bile ducts were not visualized. An upper abdominal CT scan showed a dilation of both intrahepatic bile ducts and an infiltrating mass at the bifurcation area. Magnetic resonance cholangiopanreatography showed narrowing bile duct lumen that was obstructed by the tumor at the hepatic duct bifurcation, which dilated both intrahepatic ducts. A histological examination of the ampulla of Vater revealed a well differentiated adenocarcinoma of the ampulla of Vater. The final diagnosis was a synchronous double cancer of Klatskin's tumor and an adenocarcinoma of the ampulla of Vater. (Korean J Gastrointest Endosc 2005;31:437⁣442)
Key Words: Klatskin암, 유두부암, 동시성 중복암
주요어: Klatskin's tumor, Adenocarcinoma of the ampulla of Vater, Synchronous double cancer
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