SYNCHRONOUS PRIMARY TUMORS OF THE EXTRAHEPATIC BILE-DUCT AND GALLBLADDER

Background and Objectives: This study aims to clarify clinicopathologi c characteristics of synchronous primaries of the extrahepatic bile du ct and gallbladder. Understanding multiplicity and its histologic conf irmation is an important step for successful surgical management. Meth ods: Of the 190 cases of resection of biliary tract neoplasms in this study, 10 had two separate tumors in the extrahepatic bile duct and ga llbladder, which were investigated by the microscopic mapping techniqu e for tumor extent using serial stepwise sectioning of specimens. Resu lts: Clinical diagnosis was made successfully in only two cases. Detai led histologic examination revealed seven cases with synchronous prima ries and three cases with metastatic tumors. Several microscopic param eters had additional diagnostic value. The presence of synchronous pri maries is not necessarily associated with a poor prognosis, since vile had four long-term survivors. Conclusions: Diagnosis of synchronous e xtrahepatic biliary neoplasms is rarely made preoperatively. However, aggressive resect ion and careful microscopic examination are essentia l for the successful management and diagnosis of these special cases. (C) 1997 Wiley-Liss, Inc.