Korean J Gastrointest Endosc.  2005 Dec;31(6):437-442.

A Case of Synchronous Double Cancer: Klatskin's Tumor and Ampullary Adenocarcinoma

• Lee BJ
• Lee HS
• Hyun JJ
• Kim KJ
• Kim MJ
• Choung RS
• Kim YS
• Lim HJ
• Jeen YT
• Chun HJ
• Um SH
• Lee SW
• Choi JH
• Kim CD
• Ryu HS
• Hyun JH

Abstract

Multiple cancers in the extrahepatic biliary tree are relatively rare. Many such cases are a double cancer of the common bile duct and the gallbladder. We report a case of a double primary cancer that occurred synchronously at the hilum of the extrahepatic duct and the ampulla of Vater with a review of the relevant literature. A 57-year-old man was admitted to our institution after a 15 day of painless jaundice and a urine color change. Ultrasonography showed a dilation of both intrahepatic ducts. Upper endoscopy revealed a protruding ulcerative mass at the ampulla of Vater and endoscopic retrograde cholangiography showed a dilated common bile duct and a mildly dilatated pancreatic duct, but both intrahepatic bile ducts were not visualized. An upper abdominal CT scan showed a dilation of both intrahepatic bile ducts and an infiltrating mass at the bifurcation area. Magnetic resonance cholangiopanreatography showed narrowing bile duct lumen that was obstructed by the tumor at the hepatic duct bifurcation, which dilated both intrahepatic ducts. A histological examination of the ampulla of Vater revealed a well differentiated adenocarcinoma of the ampulla of Vater. The final diagnosis was a synchronous double cancer of Klatskin's tumor and an adenocarcinoma of the ampulla of Vater.

Keyword

Klatskin's tumor; Adenocarcinoma of the ampulla of Vater; Synchronous double cancer

MeSH Terms

Adenocarcinoma*
Ampulla of Vater
Bile Ducts
Bile Ducts, Intrahepatic
Biliary Tract
Cholangiography
Common Bile Duct
Diagnosis
Endoscopy
Gallbladder
Hepatic Duct, Common
Humans
Jaundice
Klatskin's Tumor*
Middle Aged
Pancreatic Ducts
Tomography, X-Ray Computed
Ulcer
Ultrasonography