Biliary Papillomatosis and Colon Cancer: A Case Report

膽道乳頭狀瘤及大腸癌：一病例報告

廖光福(Kuan-Fu Liao) ； 鄭庚申(Ken-Sheng Chang) ； 徐章虎(Chang-Hu Hsu) ； 王煌輝(Hwang-Hui Wang) ； 陳禮平(Lai-Ping Chan) ； 楊美都(Mei-Due Yang) ； 陳永芳(Yung-Fang Chen)

《Mid-Taiwan Journal of Medicine》 3卷4期 (1998/12) Pp. 245-249

https://doi.org/10.6558/MTJM.1998.3(4).9

摘要

一名42歲男性，因間歇性發燒及腹脹至醫院住院診治。腹部超音波及電腦斷層掃瞄發現總膽管及肝內膽管有擴大現象，左側肝內膽管並有結石發生。十二指腸鏡可看到乳頭開口擴大且有粘液分泌物。內視鏡膽胰管攝影及經皮穿肝膽管攝影發現總膽管及肝內膽管有擴大情形，於擴張的膽管內並有填充缺損的表現。以上所有臨床檢查都與膽管粘液分泌瘤相似，於是病人接受了左側肝葉切除、膽囊切除、膽管結石清除及T型管引流手術。於手術中在升結腸意外發現一大腸腫瘤，故病人並接受了右側結腸切除。最後病理證實為膽道乳頭狀瘤、續發性膽汁性肝硬化及大腸癌。

關鍵字

膽道乳頭狀瘤 ； 續發性膽汁性肝硬化 ； 大腸癌

並列摘要

A 42-year-old male was admitted with intermittent fever and abdominal fullness. Abdominal ultrasonography and computed tomography (CT) showed dilatation of common bile duct (CBD), common hepatic duct (CHD) and intrahepatic duct (IHD). Supple stones were also noted. Duodenoscopy revealed a dilated papillary orifice with mucin discharge. Endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiograpy (PTC) showed dilatation of the CBD and left IHD. Movable filling defects were found within the dilated CBD and IHD. All these findings were compatible with mucinous secreting tumor in biliary tract. The patient received left lobectomy of the liver, choledocholithotomy with T-tube drainage and cholecystectomy. During operation a colonic mass over the ascending colon near the hepatic flexure area was incidentally found. Right hemicolectomy was performed. Pathological diagnosis were papillomatosis of IHD with secondary biliary cirrhosis and adenocarcinoma of colon.

並列關鍵字

biliary papillomatosis ； secondary biliary cirrhosis ； colon cancer