An adenosquamous-cell carcinoma of the bile duct is relatively rare. A 65-year-old woman was admitted to our hospital because of obstructive jaundice. Percutaneous transhepatic biliary drainage (PTBD) was performed. Cytology of the PTBD bile showed many keratinizing squamous carcinoma cells and a few clusters of adenocarcinoma cells. Cholangiography through the PTBD tube and endoscopic retrograde cholangiography, performed simultaneously, revealed irregular stenosis of the lower bile duct. Endoscopic ultrasonography also revealed a hyperechoic tumor and no choledochal stone. Pancreaticoduodenectomy was performed for the diagnosis of adenosquamous-cell carcinoma of the lower bile duct. Pathological examination of the tumor showed nodular invasive type of cholangioma and histological findings showed an adenosquamous-cell carcinoma. The patient has had hepatic metastasis for about one year, since the operation, but she is still alive and being treated with chemotherapy.
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