scholarly journals Successful surgical management of an extrahepatic biliary cystadenocarcinoma

Rare Tumors ◽  
2011 ◽  
Vol 3 (4) ◽  
pp. 114-117 ◽  
Author(s):  
Sergio Renato Pais-Costa ◽  
Sandro J. Martins ◽  
Sergio L. M. Araújo ◽  
Olímpia A. T. Lima ◽  
Marcio A. Paes ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Leak ◽  
Wall Thickening ◽  
Primary Therapy ◽  
Left Hepatic Lobe ◽  
En Bloc ◽  
Extrahepatic Bile Duct Cancer ◽  
Palpable Mass ◽  
Hepatic Lobe ◽  
Biliary Cystadenocarcinoma

Extrahepatic bile duct cancer is an uncommon disease, and few cases are curable by surgery. We report a case of extrahepatic biliary cystadenocarcinoma (BCAC) associated with atrophy of the left hepatic lobe. A 54-year old male was admitted with painless obstructive jaundice and a hepatic palpable mass noticed one month before presentation. Liver functions tests were consistent with cholestatic damage and serum carbohydrate antigen 19.9 (CA 19-9) was increased before treatment. Magnetic resonance imaging (MRI) disclosed dilatation of the left hepatic bile duct with irregular wall thickening close to the hepatic confluence, and atrophy of left hepatic lobe. The patient was submitted to en bloc extended left hepatectomy with resection of caudate lobe, hilar lymphadenectomy, and suprapancreatic biliary tree resection. All surgical margins were grossly negative, and postoperative course was uneventful, except for a minor bile leak. The patient was discharged on the 15th postoperative day; he is alive without tumor recurrence one year after primary therapy. Although technically challenging, extended en bloc resection is feasible in adults with extrahepatic BCAC and can improve survival with acceptable and manageable morbidity.

HELLP Syndrome Complicated Bile Duct Injury and Subsequent Left Hepatic Lobe Atrophy

2006 ◽  
Vol 51 (7) ◽  
pp. 1206-1212
Author(s):  
Ayse L. Mindikoglu ◽  
Shilun D. Li ◽  
Sherri L. Yong ◽  
Marc A. Borge ◽  
John Brems ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Duct Injury ◽  
Hellp Syndrome ◽  
Left Hepatic Lobe ◽  
Hepatic Lobe ◽  
Lobe Atrophy

scholarly journals Diagnosis of Cancer Spread Using Percutaneous Transhepatic Biliary Cholangioscopy-guided Ultrasonography for Malignant Bile Duct Stenosis

2001 ◽  
Vol 7 (3-4) ◽  
pp. 159-164 ◽  
Author(s):  
Hirokazu Inoue
Keyword(s):  
Bile Duct ◽  
Extrahepatic Bile Duct ◽  
Biliary Duct ◽  
Wall Thickening ◽  
Papilla Of Vater ◽  
Extrahepatic Bile Duct Cancer ◽  
Bile Duct Stenosis ◽  
Cancer Spread ◽  
Duct Stenosis ◽  
Maximum Minimum

The characteristics of sites of intramural cancer spread were examined by comparing the intraductal ultrasonography (IDUS) and wall thickening findings at sites of intramural cancer spread and non-spread, in patients with malignant bile duct stenosis who had undergone percutaneous transhepatic biliary drainage (PTBD).The subjects were ten patients with extrahepatic bile duct cancer, two with pancreatic cancer, one with cancer of the gallbladder, and one with cancer of the papilla of Vater who underwent preoperative IDUS. From these patients, 50 IDUS slices were examined with a congruent relationship with the histologic section of resected tissue. The maximum thickening, minimum thickening, maximum/minimum thickening ratio, and form factor of the medial and lateral margins of the medial hypoechoic layer were determined using diagnostic imaging, and the results were compared at sites of cancer spread and non-spread.Twelve slices were obtained from the site of stenosis, 14 from sites of cancer spread, and 24 from non-spread sites. The maximum thickening, minimum thickening, and maximum/minimum thickening ratio differed significantly between the sites of spread and the non-spread.The absolute values for wall thickening are useful for diagnosing the presence of intramural spread in patients with malignant biliary duct stenosis.

scholarly journals Giant gastric carcinosarcoma infiltrating the left hepatic lobe: a case report

2021 ◽  
pp. 214
Author(s):  
◽  
◽  
Keyword(s):  
Gastric Resection ◽  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Immunohistochemical Analysis ◽  
Needle Aspiration ◽  
Left Hepatic Lobe ◽  
En Bloc ◽  
Hepatic Lobe ◽  
Biopsy Specimens ◽  
Resected Tissue

Gastric carcinosarcoma is a rare biphasic tumor that consists of both carcinomatous and sarcomatous components. Clinical presentation and neoplastic markers are not specific for the disease. Moreover, CT scan cannot distinguish among gastric carcinoma, sarcoma or carcinosarcoma, so it is essential to perform histopathological and immunohistochemical analysis on biopsy specimens or resected tissue to ensure a correct diagnosis. A 72-year-old woman was transferred to our Department from another hospital with a diagnosis of a bleeding tumor localized on the lesser gastric curve, infiltrating the left hepatic lobe. The mass was treated as a gastric malignant mesenchymal neoplasia (gastro-intestinal stromal tumor versus sarcoma) infiltrating the liver. Owing to the bleeding, no further invasive examinations, such as fine needle aspiration biopsy, were planned. Furthermore, no neoadjuvant chemotherapy could be administered before surgery due to persistent anaemia. The scheduled surgical procedure was an atypical gastric resection with “en bloc” hepatic resection. This operation included upper polar and lesser curve resection, with tubulization of the stomach along the greater curve, as well as left lateral hepatic sectionectomy. Histopathological examination and immunohistochemical staining confirmed the diagnosis of gastric carcinosarcoma. This is first report of gastric carcinosarcoma with local liver infiltration, treated with surgical resection.

Case 17.21

2014 ◽  
pp. 829-830
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Ulcerative Colitis ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Liver Function ◽  
Liver Function Test ◽  
Test Results ◽  
Left Hepatic Lobe ◽  
Hepatic Lobe ◽  
Function Test ◽  
The Common

23-year-old man with ulcerative colitis and elevated liver function test results MIP images from 3D FRFSE MRCP (Figure 17.21.1) demonstrate focal stricture of the common bile duct at its bifurcation in the hepatic hilum. Focal beading of a mildly prominent duct in the left hepatic lobe is also noted. Axial fat-suppressed 2D SSFP images (...

scholarly journals GWAS of serum ALT and AST reveals an association of SLC30A10 Thr95Ile with hypermanganesemia symptoms

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Lucas D. Ward ◽  
Ho-Chou Tu ◽  
Chelsea B. Quenneville ◽  
Shira Tsour ◽  
Alexander O. Flynn-Carroll ◽  
...  
Keyword(s):  
Bile Duct ◽  
Extrahepatic Bile Duct ◽  
Association Studies ◽  
Missense Variant ◽  
Deficiency Anemia ◽  
Genome Wide Association Studies ◽  
Loss Of Function ◽  
Extrahepatic Bile Duct Cancer ◽  
Hepatocellular Damage ◽  
Increased Risk

AbstractUnderstanding mechanisms of hepatocellular damage may lead to new treatments for liver disease, and genome-wide association studies (GWAS) of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) serum activities have proven useful for investigating liver biology. Here we report 100 loci associating with both enzymes, using GWAS across 411,048 subjects in the UK Biobank. The rare missense variant SLC30A10 Thr95Ile (rs188273166) associates with the largest elevation of both enzymes, and this association replicates in the DiscovEHR study. SLC30A10 excretes manganese from the liver to the bile duct, and rare homozygous loss of function causes the syndrome hypermanganesemia with dystonia-1 (HMNDYT1) which involves cirrhosis. Consistent with hematological symptoms of hypermanganesemia, SLC30A10 Thr95Ile carriers have increased hematocrit and risk of iron deficiency anemia. Carriers also have increased risk of extrahepatic bile duct cancer. These results suggest that genetic variation in SLC30A10 adversely affects more individuals than patients with diagnosed HMNDYT1.

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