A Case of Synchronous Primary Cancer: Small Cell Carcinoma in the Common Bile Duct and Adenocarcinoma in the Stomach / 대한소화기내시경학회지

ABSTRACT

Primary small cell carcinoma occasionally occurs in the gastrointestinal tract; however, primary small cell carcinoma is extremely rare in common bile duct (CBD). Moreover, synchronous advanced gastric cancer has not been reported in the medical literature. We herein report on a case of synchronous primary cancer in the CBD and stomach. A 51-year-old male was admitted because of painless jaundice. Abdominal CT and ERCP showed an exophytic mass that obscured the mid-CBD and there was also intrahepatic duct dilatation. In addition, a large ulcerofungating mass was seen at the lesser curvature of the mid-body on gastrofiberscopy. The biopsy specimen obtained from ulcer was confirmed to be poorly differentiated adenocarcinoma. Explorative laparotomy was performed to remove CBD mass and gastrectomy, however, the surgery was stopped after just biopsy because of the invasion of tumor to the portal vein and difficulty in diseection. Small cell carcinoma was diagnosed from the surgical biopsy specimen by immunohistochemical stains. The tumor cells were strongly positive for neuroendocrine markers such as CD56 and synaptophysin. The patient received chemotherapy with irinotecan and cisplatin.