[Solitary Bone Metastasis in Patients with Biliary Tract Cancer-A Report of Two Cases]

Case 1:An 80-year-old man underwent laparoscopic low anterior resection and subtotal stomach-preserving pancreaticoduodenectomy with portal vein resection for rectal cancer and cholangiocarcinoma, respectively. After the operation, he complained of pain around his left shoulder and was pathologically diagnosed as cervical spine metastasis(C6)from cholangiocarcinoma. He requested only pain relief rather than aggressive medication and died 5 months after surgery. Case 2:A 66-year-old woman was diagnosed as initially unresectable locally advanced gallbladder cancer. She received 3 courses of chemotherapy with gemcitabine+cisplatin and underwent conversion surgery(S4a+S5 hepatic resection with extrahepatic bile duct resection, lymph node dissection and partial resection of duodenum). After the operation, she complained of lower limb paralysis and was diagnosed as thoracic spine metastasis(Th6)from gallbladder cancer. Her general condition was worsened rapidly due to the pain and she died 5 months after surgery. Since the prognosis is extremely poor, pain management is the essential of treatment to improve the QOL of patients with bone metastasis from biliary tract cancer.