Korean J Gastrointest Endosc.  1998 Aug;18(4):630-636.

A Case of Double Primary Cancer Associated with a Low Junction of the Cystic Duct

Affiliations
  • 1Department of Internal Medicine, Hallym University School of Medicine, Seoul, Korea.
  • 2Department of Pathology, Hallym University School of Medicine, Seoul, Korea.

Abstract

Recently it has been discovered that anomalous union of pancreaticobiliary duct (AUPBD) may play an important role in the pathogenesis of bile duct cancer. Similar to this fact, there were a few reports on the clinical significance of the low junction of the cystic duct (LJCD). LJCD refers to the situation whereby the cystic duct enters the common duct at a low position between the upper margin of the pancreas and the duodenal opening of the bile duct. The pathogenetic mechanism in LJCD is similar to AUPBD in that the pancreatic juice refluxes to the bile duct, mixes with biles, and then generates the mutagens, which act as inflammatory substances and carcinogens on the epithelium of the bile duct. A 51-year-old male who experienced dyspepsia was hospitalized due to his abnormally functioning liver and dilated common bile duct. We confirmed primary cholangiocarcinoma on the common hepatic duct and gallbladder carcinoma associated with LJCD by ERCP and pathologic review of surgical specimen. We report a case of synchronous type double primary cancer associated with LJCD with a brief review of the literatures.

Keyword

Cholangiocarcinoma; Gallbladder carcinoma; Low junction of the cystic duct; Double primary cancer

MeSH Terms

Bile
Bile Duct Neoplasms
Bile Ducts
Carcinogens
Cholangiocarcinoma
Cholangiopancreatography, Endoscopic Retrograde
Common Bile Duct
Cystic Duct*
Dyspepsia
Epithelium
Gallbladder
Hepatic Duct, Common
Humans
Liver
Male
Middle Aged
Mutagens
Pancreas
Pancreatic Juice
Carcinogens
Mutagens
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