1例肝外胆管神经内分泌癌病例报道及文献复习_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 王鑫 ,  孔静

中国医科大学附属盛京医院胆道外科(辽宁沈阳 110004);

Corresponding author：

孔静, Email: kongjing1998@163.com

Keywords：

胆管神经内分泌癌

DOI：

10.7507/1007-9424.20160166

Video：

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目的结合文献分析并总结肝外胆管神经内分泌癌的临床病理特点、诊断和治疗。方法回顾性分析我院收治的1例肝外胆管神经内分泌癌的临床病理特征并结合国内外文献进行分析总结。结果本组1例患者为男性，58岁，以右上腹间断胀痛为主诉，影像学检查示胆总管下端占位并胆管梗阻，手术治疗，术后病理诊断：胆总管末端神经内分泌癌。患者术后恢复顺利。半年后复查，肿瘤多发转移，再1个月后患者因肿瘤广泛转移而死亡。查阅国内外文献，共检索到27篇共27例已报道病例，本病临床表现与一般胆管癌相同，主要表现为黄疸和上腹部疼痛不适。治疗以手术治疗为主，部分患者辅以化疗或放疗，术后生存时间1～45个月。结论肝外胆管神经内分泌癌是罕见的胆管恶性肿瘤，临床表现以腹痛、黄疸常见。影像学检查可定位但无法定性，目前仅能通过病理及免疫组织化学确诊。治疗以手术为主，但疗效较差。

Citation： 王鑫, 孔静. 1例肝外胆管神经内分泌癌病例报道及文献复习. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(5): 612-614. doi: 10.7507/1007-9424.20160166 Copy

1.	Albores-Saavedra J, Nadji M, Henson DE, et al. Intestinal metaplasia of the gallbladder:a morphologic and immunocytochemical study. Hum Pathol, 1986, 17(6):614-620.
2.	Albores-Saavedra J, Henson DE, Klimstra D. Endocrine and benign mesenchymal tumors of the extrahepatic bile ducts//Rosai J, Sobin LH, editors. Tumor of the Gallbladder, Extrahepatic Bile Ducts, and Ampulla of Vater.3rd ed. Washington DC:Armed Forces Institute of Pathology, 2000:217-221.
3.	周晓军, 樊祥山.解读2010年消化系统肿瘤WHO分类(三).临床与实验病理学杂志, 2011, 27(11):1153-1159.
4.	Sabanathan S, Hashimi H, Nicholson G, et al. Primary oat cell carcinoma of the common bile duct. J R Coll Surg Edinb, 1988, 33(5):285-286.
5.	van der Wal AC, Van Leeuwen DJ, Walford N. Small cell neuroendocrine (oat cell) tumour of the common bile duct. Histopathology, 1990, 16(4):398-400.
6.	Nishihara K, Tsuneyoshi M, Niiyama H, et al. Composite glandular-endocrine cell carcinoma of the extrahepatic bile duct:immunohistochemical study. Pathology, 1993, 25(1):90-94.
7.	Yamamoto J, Abe Y, Nishihara K, et al. Composite glandularneuroendocrine carcinoma of the hilar bile duct:report of a case. Surg Today, 1998, 28(7):758-762.
8.	Kim SH, Park YN, Yoon DS, et al. Composite neuroendocrine and adenocarcinoma of the common bile duct associated with Clonorchis sinensis:a case report. Hepatogastroenterology, 2000, 47(34):942-994.
9.	Miyashita T, Konishi K, Noto M, et al. A case of small cell carcinoma of the common bile duct. Nihon Shokakibyo Gakkai Zasshi, 2001, 98(10):1195-1198.
10.	Edakuni G, Sasatomi E, Satoh T, et al. Composite glandularendocrine cell carcinoma of the common bile duct. Pathol Int, 2001, 51(6):487-490.
11.	Kuraoka K, Taniyama K, Fujitaka T, et al. Small cell carcinoma of the extrahepatic bile duct:case report and immunohistochemical analysis. Pathol Int, 2003, 53(12):887-891.
12.	Arakura N, Hasebe O, Yokosawa S, et al. A case of small cell carcinoma of the extrahepatic bile duct which could be diagnosed before operation. Nihon Shokakibyo Gakkai Zasshi, 2003, 100(2):190-194.
13.	Hazama K, Suzuki Y, Takahashi M, et al. Primary small cell carcinoma of the common bile duct, in which surgical treatment was performed after neoadjuvant chemotherapy:report of a case. Surg Today, 2003, 33(11):870-872.
14.	Park HW, Seo SH, Jang BK, et al. A case of primary small cell carcinoma in the common bile duct. Korean J Gastroenterol, 2004, 43(4):260-263.
15.	Thomas NE, Burroughs FH, Ali SZ. Small-cell carcinoma of the extrahepatic bile duct and concurrent clonorchiasis. Diagn Cytopathol, 2005, 32(2):92-93.
16.	李改, 易书英, 王秀艳, 等.原发性胆总管神经内分泌癌超声表现1例.中华超声影像学杂志, 2004, 13(9):686.
17.	Viana Miguel MM, García-Plata Polo E, Vidal Doce O, et al. Oat cell carcinoma of the common bile duct. Cir Esp, 2006, 80(1):43-45.
18.	Kaiho T, Tanaka T, Tsuchiya S, et al. A case of small cell carcinoma of the common bile duct. Hepatogastroenterology, 2005, 52(62):363-367.
19.	Sato K, Waseda R, Tatsuzawa Y, et al. Composite large cell neuroendocrine carcinoma and adenocarcinoma of the common bile duct. J ClinPathol, 2006, 59(1):105-107.
20.	Jeon WJ, Chae HB, Park SM, et al. A case of primary small cell carcinoma arising from the common bile duct. Korean J Gastroenterol, 2006, 48(6):438-442.
21.	Hosonuma K, Sato K, Honma M, et al. Small-cell carcinoma of the extrahepatic bile duct:a case report and review of the literature. Hepatol Int, 2008, 2(1):129-132.
22.	Nakai N, Takenaka H, Hamada S, et al. Identical p53 gene mutation in malignant proliferating trichilemmal tumour of the scalp and small cell carcinoma of the common bile duct:the necessity for therapeutic caution? Br J Dermatol, 2008, 159(2):482-485.
23.	Arakura N, Muraki T, Komatsu K, et al. Small cell carcinoma of the extrahepatic bile duct diagnosed with EUS-FNA and effectively treated with chemoradiation. Intern Med, 2008, 47(7):621-625.
24.	Okamura Y, Maeda A, Matsunaga K, et al. Small-cell carcinoma in the common bile duct treated with multidisciplinary management. J Hepatobiliary Pancreat Surg, 2009, 16(4):575-578.
25.	Demoreuil C, Thirot-Bidault A, Dagher C, et al. Poorly differentiated large cell endocrine carcinoma of the extrahepatic bile ducts. Gastroenterol Clin Biol, 2009, 33(3):194-198.
26.	Yamaguchi Y, Shimizu H, Yoneda E. A case of recurrent endocrine cell carcinoma of the common bile duct successfully treated by hepatic artery infusion with CPT-11 and CDDP. Gan To Kagaku Ryoho, 2009, 36(5):823-825.
27.	曹强, 季福, 李可为.胆管小细胞神经内分泌癌一例报道.外科理论与实践, 2009, 14(5):568-569.
28.	王付强, 尹震宇, 彭友缘, 等.肝内胆管神经内分泌癌二例报告.中华肝胆外科杂志, 2010, 16(11):888-889.
29.	Sasatomi E, Nalesnik MA, Marsh JW. Neuroendocrine carcinoma of the extrahepatic bile duct:case report and literature review. World J Gastroenterol, 2013, 19(28):4616-4623.
30.	Park SB, Moon SB, Ryu YJ, et al. Primary large cell neuroendocrine carcinoma in the common bile duct:first Asian case report. World J Gastroenterol, 2014, 20(47):18048-18052.

1. Albores-Saavedra J, Nadji M, Henson DE, et al. Intestinal metaplasia of the gallbladder:a morphologic and immunocytochemical study. Hum Pathol, 1986, 17(6):614-620.
2. Albores-Saavedra J, Henson DE, Klimstra D. Endocrine and benign mesenchymal tumors of the extrahepatic bile ducts//Rosai J, Sobin LH, editors. Tumor of the Gallbladder, Extrahepatic Bile Ducts, and Ampulla of Vater.3rd ed. Washington DC:Armed Forces Institute of Pathology, 2000:217-221.
3. 周晓军, 樊祥山.解读2010年消化系统肿瘤WHO分类(三).临床与实验病理学杂志, 2011, 27(11):1153-1159.
4. Sabanathan S, Hashimi H, Nicholson G, et al. Primary oat cell carcinoma of the common bile duct. J R Coll Surg Edinb, 1988, 33(5):285-286.
5. van der Wal AC, Van Leeuwen DJ, Walford N. Small cell neuroendocrine (oat cell) tumour of the common bile duct. Histopathology, 1990, 16(4):398-400.
6. Nishihara K, Tsuneyoshi M, Niiyama H, et al. Composite glandular-endocrine cell carcinoma of the extrahepatic bile duct:immunohistochemical study. Pathology, 1993, 25(1):90-94.
7. Yamamoto J, Abe Y, Nishihara K, et al. Composite glandularneuroendocrine carcinoma of the hilar bile duct:report of a case. Surg Today, 1998, 28(7):758-762.
8. Kim SH, Park YN, Yoon DS, et al. Composite neuroendocrine and adenocarcinoma of the common bile duct associated with Clonorchis sinensis:a case report. Hepatogastroenterology, 2000, 47(34):942-994.
9. Miyashita T, Konishi K, Noto M, et al. A case of small cell carcinoma of the common bile duct. Nihon Shokakibyo Gakkai Zasshi, 2001, 98(10):1195-1198.
10. Edakuni G, Sasatomi E, Satoh T, et al. Composite glandularendocrine cell carcinoma of the common bile duct. Pathol Int, 2001, 51(6):487-490.
11. Kuraoka K, Taniyama K, Fujitaka T, et al. Small cell carcinoma of the extrahepatic bile duct:case report and immunohistochemical analysis. Pathol Int, 2003, 53(12):887-891.
12. Arakura N, Hasebe O, Yokosawa S, et al. A case of small cell carcinoma of the extrahepatic bile duct which could be diagnosed before operation. Nihon Shokakibyo Gakkai Zasshi, 2003, 100(2):190-194.
13. Hazama K, Suzuki Y, Takahashi M, et al. Primary small cell carcinoma of the common bile duct, in which surgical treatment was performed after neoadjuvant chemotherapy:report of a case. Surg Today, 2003, 33(11):870-872.
14. Park HW, Seo SH, Jang BK, et al. A case of primary small cell carcinoma in the common bile duct. Korean J Gastroenterol, 2004, 43(4):260-263.
15. Thomas NE, Burroughs FH, Ali SZ. Small-cell carcinoma of the extrahepatic bile duct and concurrent clonorchiasis. Diagn Cytopathol, 2005, 32(2):92-93.
16. 李改, 易书英, 王秀艳, 等.原发性胆总管神经内分泌癌超声表现1例.中华超声影像学杂志, 2004, 13(9):686.
17. Viana Miguel MM, García-Plata Polo E, Vidal Doce O, et al. Oat cell carcinoma of the common bile duct. Cir Esp, 2006, 80(1):43-45.
18. Kaiho T, Tanaka T, Tsuchiya S, et al. A case of small cell carcinoma of the common bile duct. Hepatogastroenterology, 2005, 52(62):363-367.
19. Sato K, Waseda R, Tatsuzawa Y, et al. Composite large cell neuroendocrine carcinoma and adenocarcinoma of the common bile duct. J ClinPathol, 2006, 59(1):105-107.
20. Jeon WJ, Chae HB, Park SM, et al. A case of primary small cell carcinoma arising from the common bile duct. Korean J Gastroenterol, 2006, 48(6):438-442.
21. Hosonuma K, Sato K, Honma M, et al. Small-cell carcinoma of the extrahepatic bile duct:a case report and review of the literature. Hepatol Int, 2008, 2(1):129-132.
22. Nakai N, Takenaka H, Hamada S, et al. Identical p53 gene mutation in malignant proliferating trichilemmal tumour of the scalp and small cell carcinoma of the common bile duct:the necessity for therapeutic caution? Br J Dermatol, 2008, 159(2):482-485.
23. Arakura N, Muraki T, Komatsu K, et al. Small cell carcinoma of the extrahepatic bile duct diagnosed with EUS-FNA and effectively treated with chemoradiation. Intern Med, 2008, 47(7):621-625.
24. Okamura Y, Maeda A, Matsunaga K, et al. Small-cell carcinoma in the common bile duct treated with multidisciplinary management. J Hepatobiliary Pancreat Surg, 2009, 16(4):575-578.
25. Demoreuil C, Thirot-Bidault A, Dagher C, et al. Poorly differentiated large cell endocrine carcinoma of the extrahepatic bile ducts. Gastroenterol Clin Biol, 2009, 33(3):194-198.
26. Yamaguchi Y, Shimizu H, Yoneda E. A case of recurrent endocrine cell carcinoma of the common bile duct successfully treated by hepatic artery infusion with CPT-11 and CDDP. Gan To Kagaku Ryoho, 2009, 36(5):823-825.
27. 曹强, 季福, 李可为.胆管小细胞神经内分泌癌一例报道.外科理论与实践, 2009, 14(5):568-569.
28. 王付强, 尹震宇, 彭友缘, 等.肝内胆管神经内分泌癌二例报告.中华肝胆外科杂志, 2010, 16(11):888-889.
29. Sasatomi E, Nalesnik MA, Marsh JW. Neuroendocrine carcinoma of the extrahepatic bile duct:case report and literature review. World J Gastroenterol, 2013, 19(28):4616-4623.
30. Park SB, Moon SB, Ryu YJ, et al. Primary large cell neuroendocrine carcinoma in the common bile duct:first Asian case report. World J Gastroenterol, 2014, 20(47):18048-18052.

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1例肝外胆管神经内分泌癌病例报道及文献复习

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