Distal Cholangiocarcinoma with Gastric Metastasis Mimicking Early Gastric Cancer

Abstract

We report an unusual case of distal cholangiocar-cinoma with gastric metastasis mimicking early gastric cancer. A 67-year-old woman presented with a 4-month history of abdominal pain after eating. Comput-ed tomography showed a malignant tumor of the common bile duct located just above the intrapan-creatic segment, and endoscopy revealed a 2-cm, flat, elevated lesion with convergence of the surrounding folds, situated at the gastric angle. Based on the en-doscopic biopsy results, an adenocarcinoma, thought to be an early gastric cancer, was diagnosed. The patient underwent Whipples’s operation. Histopatho-logical findings showed that the adenocarcinomatous tissue was clearly demarcated and infiltrated the gas-tric mucosa and submucosa, leaving the gastric su-perficial mucosa intact. Both tumors showed similar pathological features and were positive for cytokeratin (CK)-19 and CK-7. These finding suggest distal chol-angiocarcinoma with gastric metastasis. (Gut an