Signet-ring cell carcinoma coexisting with adenocarcinoma arising in a choledochal cyst: report of a case

Surg Today. 2015 Aug;45(8):1049-52. doi: 10.1007/s00595-014-1049-3. Epub 2014 Oct 29.

Abstract

Signet-ring cell carcinoma (SRCC) is rare in the biliary system. We report a case of SRCC coexisting with adenocarcinoma, arising in a choledochal cyst of the extrahepatic bile duct. The patient was a 52-year-old man, hospitalized for the investigation of jaundice and pruritus. Abdominal computed tomography and magnetic resonance cholangiopancreatography showed a huge choledochal cyst and distal common bile duct cancer. The patient underwent a pancreaticoduodenectomy with extended lymph node dissection. Histologic examination confirmed an SRCC coexisting with adenocarcinoma arising in a choledochal cyst. Postoperative chemotherapy had to be discontinued after only two cycles because the patient suffered serious side effects. Recurrence was detected in the bilioenteric anastomosis 4 months after surgery, and he died 6 months after surgery. To our knowledge, this represents the first case of SRCC arising in a choledochal cyst of the extrahepatic bile duct ever to be reported.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / surgery*
  • Bile Ducts, Extrahepatic / surgery*
  • Carcinoma, Signet Ring Cell / diagnosis
  • Carcinoma, Signet Ring Cell / surgery*
  • Cholangiopancreatography, Magnetic Resonance
  • Choledochal Cyst / diagnosis
  • Choledochal Cyst / surgery*
  • Common Bile Duct Neoplasms / diagnosis
  • Common Bile Duct Neoplasms / surgery*
  • Fatal Outcome
  • Humans
  • Lymph Node Excision
  • Male
  • Middle Aged
  • Neoplasms, Multiple Primary*
  • Pancreaticoduodenectomy
  • Recurrence