A Case of Squamous Cell Carcinoma of the Distal Common Bile Duct

ABSTRACT

Squamous cell carcinoma of the extrahepatic bile duct is very rare. Only limited information is available concerning its pathogenesis and prognosis, although it is reported to be associated with choledocolithiasis, recurrent pyogenic cholangitis, clonorchiasis, choledochal cyst formation, and primary sclerosing cholangitis. Therefore, we present a case of squamous cell carcinoma of the distal common bile duct. A 64-year-old male patient presented with abdominal pain and obstructive jaundice. Computed tomography and endoscopic retrograde cholangiography showed thickening of the wall and a segmental stricture of the distal common bile duct, and the biopsy confirmed poorly differentiated carcinoma with marked squamous differentiation. The patient underwent a pylorus-preserving pancreaticoduodencetomy. Histological examination revealed that the tumor invaded the pancreas and metastasized to regional lymph nodes (pT3N1M0). The patient developed multiple liver metastases 30 days later and died of rapidly progressive metastatic disease to the liver 5 months following resection. Squamous cell carcinoma of the distal bile duct with lymph node metastasis had a very poor prognosis, even though curative resection was performed.