[pT2 Gallbladder Cancer with Suspected Intrapancreatic Bile Duct Recurrence Four Years Postoperatively-A Case Report]

We report a case of intrapancreatic bile duct solitary recurrence 4 years postoperatively for pT2 gallbladder cancer. A 58-year-old woman underwent laparoscopic cholecystectomy for a growing gallbladder polyp. Her histopathological findings included well-differentiated adenocarcinoma, pT2a, ly0, v0, ne0, pCM0, pEM0, R0. Consequently, gallbladder bed resection, extrahepatic bile duct resection, choledochojejunostomy, and lymph node dissection were performed. Following which, residual cancer was not reported. Postoperatively, abdominal computed tomography(CT)scans were performed at 6-month intervals. A 3-cm mass with poor contrast was observed in the pancreatic head 4 years postoperatively without main pancreatic duct dilation or pancreatic parenchymal atrophy, and the mass was considered as a recurrent nodule of gallbladder cancer. The recurrent mass could no longer be identified after three courses of GEM+CDDP combination therapy. Subsequently, the disease was determined to be curable, and a pancreaticoduodenectomy was performed. Her postoperative course was uneventful, and the patient was discharged after 30 days. A clearly demarcated white nodular mass measuring 5 mm in diameter was observed in the posterior part of the pancreas, which was a poorly differentiated adenocarcinoma. In this case, the tumor was macroscopically and histologically atypical for primary cancer and was considered a gallbladder cancer recurrence with its main site in the bile duct.