Familial polyposis coli associated with bile duct cancer

The clinical features and surgical management of two patients with primary adenocarcinoma of the bile duct in association with familial polyposis coli are described. The first patient had had subtotal colectomy for familial polyposis coli, and several resections of duodenal tumors. Carcinoma developed in the common bile duct and was treated with intubation and radiation therapy; he is still alive 2 years later. A second patient with cancer at the bifurcation of the bile ducts was treated with intubation and radiotherapy; 1 year later she had intestinal hemorrhage from a sigmoid colon cancer, and multiple colonic polyps were noted. We believe that this is the first report in the English literature of biliary cancer in association with familial polyposis coli or Gardner's syndrome.