Composite neuroendocrine and adenocarcinoma of the common bile duct associated with Clonorchis sinensis: A case report

Hoon Kim Se Hoon Kim, Nyun Park Young Nyun Park, Sup Yoon Dong Sup Yoon, Joon Lee Se Joon Lee, Sik Yu Jeong Sik Yu, Woong Noh Tae Woong Noh

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Abstract

The biliary tract has neuroendocrine cells of endoderm origin similar to the gastrointestinal tract, however neuroendocrine tumors of the biliary tract are rare. We report a composite glandular-endocrine cell carcinoma of the common bile duct in a 64-year-old Korean man which was associated with Clonorchis sinensis. The patient complained of right upper quadrant abdominal pain. Several parasites of Clonorchis sinensis were removed during the percutaneous transbiliary drainage. Endoscopic retrograde cholangiopancreatography revealed a polypoid mass (3x3cm) with central ulceration in the common bile duct. Pancreaticoduodenectomy was performed. Microscopic examination of the tumor revealed a composite small cell neuroendocrine carcinoma and adenocarcinoma. The small cell carcinoma component showed positive reaction to chromogranin A and neuron-specific enolase and it was located mainly in the deeper portion of the mass. The well-differentiated adenocarcinoma component showed a positive reaction to carcinoembryonic antigen and it was situated in the superficial portion of the mass. Exclusively, the small cell component metastasized to the lymph node. It is suggested that this tumor could arise from a multipotential stem cell and showed neuroendocrine and glandular differentiation and that Clonorchis sinensis could be a predisposing factor, as in cholangiocarcinoma.

Original languageEnglish
Pages (from-to)942-944
Number of pages3
JournalHepato-gastroenterology
Volume47
Issue number34
Publication statusPublished - 2000

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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    Se Hoon Kim, H. K., Young Nyun Park, N. P., Dong Sup Yoon, S. Y., Se Joon Lee, J. L., Jeong Sik Yu, S. Y., & Tae Woong Noh, W. N. (2000). Composite neuroendocrine and adenocarcinoma of the common bile duct associated with Clonorchis sinensis: A case report. Hepato-gastroenterology, 47(34), 942-944.