Mixed Ductal–Endocrine Carcinoma of the Pancreas with Synchronous Papillary Carcinoma-In-Situ of the Common Bile Duct: A Case Report and Literature Review– Synchronous Pancreatic and Bile Duct Tumors

This report is a case of a 58-year-old woman with a mixed ductal–endocrine carcinoma of the pancreas and a synchronous carcinoma-in-situ of the common bile duct. She presented with intractable itching from obstructive jaundice. Magnetic resonance imaging scan showed dilated intrahepatic biliary and common bile ducts. Endoscopic retrograde cholangiopancreatography revealed an ulcerated lesion of the ampulla. Biopsies from this lesion showed adenocarcinoma. Subsequently, pancreatoduodenectomy was performed for the diagnosis of peri-ampullary carcinoma. Gross examination revealed a 2-cm irregular, ulcerated lesion obstructing the distal 0.5 cm of the common bile duct within the head of the pancreas. On histopathological examination, it was discovered that this lesion contained two separate neoplasms: papillary carcinoma-in-situ of the intraparenchymal portion of the common bile duct and a mixed ductal–endocrine carcinoma of the pancreas. Mixed ductal–endocrine carcinoma of the pancreas is very rare. Finding it in conjunction with a synchronous, overlying papillary carcinoma carcinoma-in-situ of the common bile duct has not been previously described.

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A Case of Acinar Cell Carcinoma of the Pancreas with Invasion into the Common Bile Duct

The Japanese Journal of Gastroenterological Surgery ◽

10.5833/jjgs.43.1264 ◽

2010 ◽

Vol 43 (12) ◽

pp. 1264-1269

Author(s):

Yoshio Matsui ◽

Kazuhito Yano ◽

Youichirou Tamura ◽

Takahisa Kageyama

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Cell Carcinoma ◽

Acinar Cell ◽

Acinar Cell Carcinoma ◽

Carcinoma Of The Pancreas ◽

The Common

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Primary endoscopic papillotomy (EPT) in patients with stones in the common bile duct and the gallbladder in situ: A 5-8-year follow-up study

World Journal of Surgery ◽

10.1007/bf01658496 ◽

1988 ◽

Vol 12 (1) ◽

pp. 111-115 ◽

Cited By ~ 38

Author(s):

Arne R. Rosseland ◽

Jan Helge Solhaug

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Endoscopic Papillotomy ◽

Follow Up Study ◽

The Common ◽

Gallbladder In Situ

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Carcinoma in situ arising in a tubulovillous adenoma of the distal common bile duct: A case report

World Journal of Gastroenterology ◽

10.3748/wjg.14.4705 ◽

2008 ◽

Vol 14 (29) ◽

pp. 4705 ◽

Cited By ~ 8

Author(s):

Bum-Soo Kim ◽

Sun-Hyung Joo ◽

Kwang-Ro Joo

Keyword(s):

Case Report ◽

Bile Duct ◽

Common Bile Duct ◽

Carcinoma In Situ ◽

Tubulovillous Adenoma ◽

Distal Common Bile Duct

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Possible Protective Effect of Onion Supplementation on Hepatic Functional and Structural Alterations Induced by Cholestasis

QJM ◽

10.1093/qjmed/hcaa065.003 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A A Mohamed ◽

D A Saad ◽

M M Francis ◽

F A Mohamed

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Plasma Levels ◽

Histopathological Examination ◽

Direct Bilirubin ◽

Hepatic Tissue ◽

Control Group ◽

Tissue Samples ◽

Tnf Α ◽

The Common

Abstract Background Cholestasis is the obstruction or the reduction in bile flow that results in intrahepatic accumulation of bile constituents, which progresses to develop liver pathology. Common bile duct ligation (BDL) in rodents is an experimental model of cholestasis that has been carried out in research for many years. BDL model of cholestatic liver injury involves other mechanisms, including oxidative stress, inflammation, and fibrogenesis. Antioxidant, antiinflammatory or antiapoptotic properties gained much interest for the amelioration of liver dysfunction. Aim the aim of this study is to assess the possible protective effects of onion supplementation on hepatic structural and functional alterations induced by BDL in rats, which reflect the effects of cholestasis resulting from intrahepatic accumulation of bile. Methods Thirty adult female Wistar rats were randomly and equally allocated into three groups: (1) control group, (2) BDL group; subjected to ligation of the common bile duct and (3) Onion-supplemented BDL groups (O-BDL). Both control and BDL groups received distilled water (solvent for onion powder) daily by gavage for 4 weeks. Onion-supplemented BDL group (O-BDL); subjected to ligation of the common bile duct and then received 500 mg/kg of onion powder dissolved in distilled water, daily by gavage for 4 weeks. At the end of the experimental period, plasma levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), direct bilirubin, total proteins, total antioxidant capacity (TAC), tumor necrosis factor-α (TNF-α), and hepatic tissue level of malondialdehyde (MDA) and transforming growth factor-β (TGF-β) were measured for all groups. In addition, histopathological examination of liver tissue samples was performed for the three groups. Results Plasma levels of ALT, AST, ALP, direct bilirubin, TNF-α and hepatic tissue levels of MDA and TGF-β were significantly increased and TAC was significantly decreased in the BDL group compared to the control group. In addition, altered architecture was detected in hepatic tissue samples of BDL group. Onion supplementation significantly decreased the plasma levels of ALT, AST, ALP, direct bilirubin, TNF-α and hepatic tissue levels of MDA and TGF-β in the O-BDL group when compared to the BDL group. Total proteins level was not significantly different among all the studied groups. In addition in O-BDL group, histopathological examination of liver revealed near normal structure of hepatic tissue. Conclusion BDL induces hepatic structural alterations and functional disturbances. Onion supplementation inhibits inflammation and oxidative insults that associate BDL, and subsequently protects against BDL-induced liver injury.

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