{"title":"Adenosquamous Carcinoma of the Distal Common Bile Duct: A Case of a Rare Type of Cholangiocarcinoma.","authors":"Samalai Kanagasabapathy, Duminda Subasinghe, Sivasuriya Sivaganesh, Harshima Wijesinghe","doi":"10.1177/2632010X221099884","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Adenosquamous carcinoma (ASC) is a rare subtype of the conventional adenocarcinoma of the bile duct. The clinico-pathological characteristics of this entity are poorly understood partly due to its rarity.</p><p><strong>Case summary: </strong>A 67-year-old ASA II male presented with obstructive jaundice subsequently complicated by cholangitis. CT abdomen showed dilatation of the intra and extrahepatic biliary tree. Endoscopic retrograde cholangiopancreatography revealed a stricture with a mucosal growth at the ampulla of Vater. He had a pancreaticoduodenectomy and the distal common bile duct tumour identified in the specimen was on histology an adenosquamous carcinoma (ASC) of the extrahepatic bile duct.</p><p><strong>Discussion: </strong>ASCs are considered to have more aggressive tumour biology compared to adenocarcinomas. The presence of a squamous component at the invasive front relates to its poor prognosis. Surgery is the curative option, but with a high propensity for early recurrence and distant metastases. The scarcity of reports on the clinicopathological course of ASC have resulted in a lack of standardised care pathways.</p><p><strong>Conclusion: </strong>A better understanding of the clinicopathological characteristics, biological behaviour and disease progression of ASC will aid therapeutic options and prognostication.</p>","PeriodicalId":53204,"journal":{"name":"Clinical Pathology","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3e/23/10.1177_2632010X221099884.PMC9121450.pdf","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Pathology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/2632010X221099884","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PATHOLOGY","Score":null,"Total":0}
引用次数: 1
Abstract
Introduction: Adenosquamous carcinoma (ASC) is a rare subtype of the conventional adenocarcinoma of the bile duct. The clinico-pathological characteristics of this entity are poorly understood partly due to its rarity.
Case summary: A 67-year-old ASA II male presented with obstructive jaundice subsequently complicated by cholangitis. CT abdomen showed dilatation of the intra and extrahepatic biliary tree. Endoscopic retrograde cholangiopancreatography revealed a stricture with a mucosal growth at the ampulla of Vater. He had a pancreaticoduodenectomy and the distal common bile duct tumour identified in the specimen was on histology an adenosquamous carcinoma (ASC) of the extrahepatic bile duct.
Discussion: ASCs are considered to have more aggressive tumour biology compared to adenocarcinomas. The presence of a squamous component at the invasive front relates to its poor prognosis. Surgery is the curative option, but with a high propensity for early recurrence and distant metastases. The scarcity of reports on the clinicopathological course of ASC have resulted in a lack of standardised care pathways.
Conclusion: A better understanding of the clinicopathological characteristics, biological behaviour and disease progression of ASC will aid therapeutic options and prognostication.