J Pathol Transl Med.  2019 Mar;53(2):112-118. 10.4132/jptm.2018.09.03.

Squamous Cell Carcinoma of the Extrahepatic Common Hepatic Duct

• Kang M
• Kim NR
• Chung DH
• Cho HY
• Park YH

• KMID: 2465450
• DOI: http://doi.org/10.4132/jptm.2018.09.03

Abstract

We report a rare case of hilar squamous cell carcinoma. A 62-year-old Korean woman complaining of nausea was referred to our hospital. Her biliary computed tomography revealed a 28 mm-sized protruding solid mass in the proximal common bile duct. The patient underwent left hemihepatectomy with S1 segmentectomy and segmental excision of the common bile duct. Microscopically, the tumor was a moderately differentiated squamous cell carcinoma of the extrahepatic bile duct, without any component of adenocarcinoma or metaplastic portion in the biliary epithelium. Immunohistochemically, the tumor was positive for cytokeratin (CK) 5/6, CK19, p40, and p63. Squamous cell carcinoma of the extrahepatic bile duct is rare. To date, only 24 cases of biliary squamous cell carcinomas have been reported. Here, we provide a clinicopathologic review of previously reported extrahepatic bile duct squamous cell carcinomas.

Keyword

Carcinoma, squamous cell; Klatskin tumor; Hepatic duct, common; Hilum; Chemotherapy

MeSH Terms

Adenocarcinoma
Bile Ducts, Extrahepatic
Carcinoma, Squamous Cell*
Common Bile Duct
Drug Therapy
Epithelial Cells*
Epithelium
Female
Hepatic Duct, Common*
Humans
Keratins
Klatskin Tumor
Mastectomy, Segmental
Middle Aged
Nausea
Keratins

Figure

• 

  Fig. 1. (A) Computed tomography reveals perihilar cholangiocarcinoma with metastatic lymph nodes. (B) Magnetic resonance cholangiopancreatography shows strictures of the left intrahepatic duct to common hepatic duct.

• 

  Fig. 2. (A) The gross specimen revealed a protruded mass (arrows) accounting for all layers of the hepatic duct wall. (B) Histologically, thickened papillary squamous epithelium shows moderately differentiated dyskeratotic squamous cells with keratin pearls with stromal invasion. (C) Surface epithelium shows a transition from unilayered cuboidal to squamous epithelium (arrow). (D) Immunohistochemically, the tumor cells are positive for p63 (left) and p40 (right).

• 

  Fig. 3. Ultrastructurally, ovoid-shaped tumor cells have cytoplasmic tonofilaments (white arrows) and are connected with wellformed desmosomes (black arrows, ×2,500).

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