腺腫の癌化を強く疑わせた15歳男児の腎不全合併下部胆管癌の1例

概要

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We experienced the young patient (15 year old) who had had obstructive jaundice, and the endscopic retrograde cholangiogram showed a long stenosis of the distal biliary tract. This patient had been treated for chronic renal failure for 10 years at the department of medicine. Frequent microscopic examination of bile showed Papanicoloau class II-IIIb. As the benign tumor like adenoma was most suspected, cholecysto-duodenostomy was performed. However, the microscopic findings of the tumor showed adenocarcinoma and tubular adenoma in the same specimen. As the renal function was decompensated after the first operation, it took 6 months untill the radical operation (pancreato-duodenectomy, Child's operation). On the macroscopic and microscopic findings of the resected tumor, the invasion extended beyond the choledocal wall but not remarkable in pancreatic stroma. The metastatic lymph node was not confirmed. Postoperative diagnosis; Bi, circ., c, 1.2×0.9×0.9, Hinf_0, G_0, Panc_1, D_0, V_0, P_0, N (-), stage I. The developmental process of the tumor was discussed that the adenocarcinoma had been arised from adenoma. This case was very interesting from clinical and pathological views.
日本小児外科学会の論文
1984-12-20