ADENOSQUAMOUS CARCINOMA WITH DIFFERENT MORPHOLOGIC AND HISTOLOGIC COMPONENTS ARISING FROM THE INTRAHEPATIC BILE-DUCT - REPORT OF A CASE

A very rare fern of adenosquamous carcinoma arising from the intrahepa tic bile duct which had diverse morphologic and histologic components is presented. A 77-year-old female complained of relapsing febrile att ach accompanied by upper abdominal pain. From the imaging studies, whi ch revealed an atrophic left lobe with dilated intrahepatic bile duct, cholangiocarcinoma constricting the orifice of B3 was considered the most likely diagnosis. Surgery, which included resection of the left h epatic and caudate lobes with lymph node dissection, revealed an atrop hic lateral segment indicating recurrent inflammation. Pathologic exam ination revealed a combined tremor composed of papillary squamous cell carcinoma arising at the orifice of the lateral inferior segmental bi le duct and intramucosal adenocarcinoma spreading distal to the polypo id tumor. Two different components were connected with a thin stalk, b ut there was no apparent transitional zone. Contrary to ordinary mass- forming adenosquamous carcinoma in the Liver, which is reported to pur sue a very rapid, fatal course, an uneventful recovery and has remaine d in good health without recurrence for 2 years and 3 months since sur gery.