Adenosquamous Carcinoma of the Choledochus

Abstract

The patient was an 86-year-old man who was admitted with obstructive jaundice. Computed tomography revealed a tumor in the hilar choledochus with peripheral hepatic duct dilatation. Endoscopic cholangiography (ERC) demonstrated the defect in the choledochus. Brushing cytology during ERC showed Orange-G-philic keratinized atypical cells, which led to a diagnosis of squamous cell carcinoma. Chemotherapy with tegafur-gimeracil-oteracil potassium was ineffective and was discontinued due to adverse effects. The patient died 5 months after the diagnosis and autopsy revealed tubular adenocarcinoma of the hilar bile duct with squamous cell carcinoma component. Progression of the disease might influence the distribution of adenosquamous carcinoma. The clinicopathological sequence of adenosquamous carcinoma of the choledochus was documented.

Adenosquamous Carcinoma of the Distal Common Bile Duct: A Case of a Rare Type of Cholangiocarcinoma

“…Lymph node metastases may show an adenocarcinoma component, a squamous cell component or a mixture of the two components. 4,7 ASC is regarded as a more aggressive tumour with a less favourable prognosis than its adenocarcinoma counterparts. 3,4 The poor survival for patients with ASC may be due in part to it association with more aggressive pathological features including deeper invasion, frequent duodenal invasion, and higher disease stage.…”

“…Surgery remains the treatment of choice for resectable disease in ASC, as for adenocarcinoma, 6,7 with early-stage disease showing better survival. There are no standardised regimes of management for ASC-ECC due to small numbers of reported cases and sparse data.…”

“…Lymph node metastases may show an adenocarcinoma component, a squamous cell component or a mixture of the two components. 4,7…”

“…Where a biopsy is available, it may represent only 1 of the 2 malignant components. 7 Only few cases of ASC have been reported to date 1,6,8,9 and population-based studies are also limited. 3,4,10,11 We report a case of ASC of the distal CBD and discuss the relevant literature.…”

Case Report: Trastuzumab Treatment in Adenosquamous Carcinoma of the Extrahepatic Biliary Tract With Her-2 Amplification

“…There is no standard management for adenosquamous carcinoma due to the low incidence rate. The management of adenosquamous carcinoma always refers to the treatment of adenocarcinoma, which has no satisfactory effect and worsening survival than adenocarcinoma ( 6 ). Surgery is the only curative therapy, but most patients lose the chance of the operation at the time of diagnosing and even if patients receive surgery, they would quickly relapse ( 7 ).…”