Department of Internal Medicine and Surgery, Daegu Fatima Hospital, Daegu, Korea
ABSTRACT
Mixed adenoneuroendocrine carcinoma occurs rarely in the biliary tract. We report a case of mixed adenoneuroendocrine carcinoma of common bile duct, based on the World Health Organization 2010 classification. A 79-year-old woman complained of right abdominal pain for 2 weeks. ERCP and MRCP revealed a narrow common bile duct with upstream dilatation and biopsy of common bile duct suggested only adenocarcinoma. Pancreaticoduodenectomy was performed, and a tumor was composed of both neuroendocrine carcinoma and adenocarcinoma. Immunohistochemically, neuroendocrine components were reactive for cytokeratin and synaptophysin. The neuroendocrine and exocrine components occurred in separate areas of the same lesion. Liver metastasis was developed at 16 months after surgery. The optimal strategy of management of mixed adenoneuroendocrine carcinoma involving the biliary tract is unknown because it is very unusual. However, more cases will be helpful to demonstrate clinical course and make a decision about management plans
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