Korean J Gastrointest Endosc > Volume 38(5); 2009 > Article
Korean Journal of Gastrointestinal Endoscopy 2009;38(5): 303-308.
진행성 위암과 동시에 발생한 총담관 원발성 소세포암종 1예
고려대학교 의과대학 내과학교실, *병리학교실
A Case of Synchronous Primary Cancer: Small Cell Carcinoma in the Common Bile Duct and Adenocarcinoma in the Stomachs
Yong Dae Kwon, M.D., Chang Duck Kim, M.D., Yong Sik Kim, M.D., Yoon Tae Jeen, M.D., Hoon Jai Chun, M.D., Soon Ho Um, M.D., Ho Sang Ryu, M.D. and Yang Seok Chae, M.D.*
Departments of Internal Medicine and *Pathology, Korea University College of Medicine, Seoul, Korea
Primary small cell carcinoma occasionally occurs in the gastrointestinal tract; however, primary small cell carcinoma is extremely rare in common bile duct (CBD). Moreover, synchronous advanced gastric cancer has not been reported in the medical literature. We herein report on a case of synchronous primary cancer in the CBD and stomach. A 51-year-old male was admitted because of painless jaundice. Abdominal CT and ERCP showed an exophytic mass that obscured the mid-CBD and there was also intrahepatic duct dilatation. In addition, a large ulcerofungating mass was seen at the lesser curvature of the mid-body on gastrofiberscopy. The biopsy specimen obtained from ulcer was confirmed to be poorly differentiated adenocarcinoma. Explorative laparotomy was performed to remove CBD mass and gastrectomy, however, the surgery was stopped after just biopsy because of the invasion of tumor to the portal vein and difficulty in diseection. Small cell carcinoma was diagnosed from the surgical biopsy specimen by immunohistochemical stains. The tumor cells were strongly positive for neuroendocrine markers such as CD56 and synaptophysin. The patient received chemotherapy with irinotecan and cisplatin. (Korean J Gastrointest Endosc 2009; 38:303-308)
Key Words: Synchronous primary cancer, Common bile duct, Small cell carcinoma, Stomach cancer
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