LONG-TERM SURVIVOR WITH CERVICAL AND AXILLARY LYMPH NODES METASTASES FROM A MIDDLE BILE DUCT CARCINOMA

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A 75-year-old man was admitted for the treatment of obstructive jaundice in July 1996 and was subsequently diagnosed as having a bile duct carcinoma. The patient underwent a radical bile duct resection with portal resection in August 1996. Pathological diagnosis revealed a moderately differentiated tubular adenocarcinoma, stage III. The left cervical lymph nodes gradually became swollen, and a tumorectomy was performed 10 months later. Pathological examination revealed a metastases of the bile duct carcinoma. The patient underwent two subsequent tumorectomies for left axillary lymph node swelling, 24 and 32 months later. The surgical specimens were identified as pathologically identical metastases of the bile duct carcinoma. The patient remains disease-free 7 years after undergoing the initial bile duct resection. The prognosis of patients with advanced bile duct carcinoma, especially those with lymph node metastases, is considered to be poor. Herein, we report the rare case of a 7-year longterm survivor who received 3 tumorectomies for distant lymph node metastases after an initial operation for advanced middle bile duct carcinoma.
日本臨床外科学会の論文