ID | 63278 |
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Author |
Tamaki, Ayano
Center for Graduate Medical Education, Okayama University Hospital
Tani, Yuma
Department of Gastroenterological Surgery, Okayama University Hospital
Sato, Hiroki
Department of Gastroenterological Surgery, Okayama University Hospital
Yoshida, Ryuichi
Department of Gastroenterological Surgery, Okayama University Hospital
ORCID
Kaken ID
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Yasui, Kazuya
Department of Gastroenterological Surgery, Okayama University Hospital
Horiguchi, Shigeru
Department of Gastroenterology and Hepatology, Okayama University Hospital
Kuise, Takashi
Department of Gastroenterological Surgery, Okayama University Hospital
Umeda, Yuzo
Department of Gastroenterological Surgery, Okayama University Hospital
Kaken ID
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Yoshida, Kazuhiro
Department of Gastroenterological Surgery, Okayama University Hospital
Fuji, Tomokazu
Department of Gastroenterological Surgery, Okayama University Hospital
Kumano, Kenjiro
Department of Gastroenterological Surgery, Okayama University Hospital
Yagi, Takahito
Department of Gastroenterological Surgery, Okayama University Hospital
Kaken ID
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Fujiwara, Toshiyoshi
Department of Gastroenterological Surgery, Okayama University Hospital
ORCID
Kaken ID
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Abstract | Background Mixed neuroendocrine-non-neuroendocrine neoplasm (MINEN) is a rare disease and there is scarce literature on its diagnosis, treatment, and prognosis. We encountered two unusual cases of MINEN in the biliary tract, one in the ampulla of Vater and the other in the distal bile duct. In this report, we describe the clinical course of these two cases in detail. Case presentation Case 1: A 69-year-old woman presented with a chief complaint of epigastric pain. When endoscopic sphincterotomy and retrograde biliary drainage were performed for gallstone pancreatitis, an ulcerated lesion was found in the ampulla of the Vater. Based on the biopsy results, the lesion was diagnosed as the ampulla of Vater carcinoma and subtotal stomach-preserving pancreatoduodenectomy (SSPPD) was performed. Postoperative histopathological examination revealed the coexistence of adenocarcinoma and neuroendocrine carcinoma components, consistent with the diagnosis of MINEN. In addition, lymph node metastasis was found on the dorsal side of the pancreas and the metastatic component was adenocarcinoma. Adjuvant chemotherapy with etoposide and cisplatin was administered for 6 months, and presently the patient is alive without recurrence 64 months after surgery. Case 2: A 79-year-old man presented with a chief complaint of anorexia. Cholangiography showed severe stenosis of the distal bile duct. A biopsy was conducted from the stenotic lesion and it revealed the lesion to be adenocarcinoma. A diagnosis of distal bile duct carcinoma was made, and SSPPD was performed. Histopathological examination revealed the coexistence of adenocarcinoma and neuroendocrine carcinoma components, and the tumor was confirmed as MINEN of the distal bile duct. No adjuvant chemotherapy was administered due to the poor performance status. 7 months later, the patient was found to have a liver metastasis. Conclusion We experienced two valuable cases of biliary MINEN. To identify better treatments, it is important to consider the diversity of individual cases and to continue sharing a variety of cases with different presentations.
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Keywords | Mixed neuroendocrine-non-neuroendocrine neoplasm
Adjuvant chemotherapy
Ampulla of vater
Distal bile duct
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Published Date | 2022-03-02
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Publication Title |
Surgical Case Reports
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Volume | volume8
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Issue | issue1
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Publisher | Springer
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Start Page | 38
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ISSN | 2198-7793
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Content Type |
Journal Article
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language |
English
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OAI-PMH Set |
岡山大学
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Copyright Holders | © The Author(s) 2022.
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File Version | publisher
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PubMed ID | |
DOI | |
Web of Science KeyUT | |
Related Url | isVersionOf https://doi.org/10.1186/s40792-022-01386-w
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License | http://creativecommons.org/licenses/by/4.0/
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