COMPOSITE GLANDULAR-NEUROENDOCRINE CARCINOMA OF THE HILAR BILE-DUCT -REPORT OF A CASE

We report herein an unusual case of a composite glandular-neuroendocri ne carcinoma of the hilar bile duct. A 71-year-old Japanese woman was admitted to our hospital suffering from general fatigue, progressive j aundice, and a high fever. Computed tomography and angiography finding s revealed a solid hypervascular mass in the hepatic hilus, Thus, a su bsegmentectomy of the liver (S-4, S-5) and bile duct resection with ly mphnode dissection were performed. A tumor measuring 6.0 x 3.0 cm was found to be located in the bile duct of the hepatic hilus. Histologica lly, the tumor was composed of well-differentiated adenocarcinoma and small cell neuroendocrine carcinoma cells, with a histological transit ion between the two components, Grimelius' method revealed the presenc e of diffuse positive tumor cells in neuroendocrine carcinoma, The neu roendocrine tumor cells were also diffusely immunoreactive to chromogr anin A, To the best of our knowledge, only 22 previous cases of compos ite glandular-neuroendocrine carcinoma in the biliary tract have been reported; however, this is the first case report of a clearly composit e tumor of the hilar bile duct.