Occupational cholangiocarcinoma diagnosed 18 years after the end of exposure to 1,2-dichloropropane and dichloromethane at a printing company: a case report

Abstract Background Cholangiocarcinoma due to exposure to 1.2-dichloropropane (DCP) or dichloromethane (DCM) is classified as occupational cholangiocarcinoma. We report a case of occupational cholangiocarcinoma diagnosed 18 years after the end of exposure to organic solvents at a printing company. C...

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Main Authors: Masahiko Kinoshita, Yasunori Sato, Hiroko Nebiki, Yutaka Tamamori, Naomi Ishii, Takeshi Inoue, Genya Hamano, Akishige Kanazawa, Shoji Kubo
Format: Article
Language:English
Published: Japan Surgical Society 2019-04-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-019-0624-7
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author Masahiko Kinoshita
Yasunori Sato
Hiroko Nebiki
Yutaka Tamamori
Naomi Ishii
Takeshi Inoue
Genya Hamano
Akishige Kanazawa
Shoji Kubo
author_facet Masahiko Kinoshita
Yasunori Sato
Hiroko Nebiki
Yutaka Tamamori
Naomi Ishii
Takeshi Inoue
Genya Hamano
Akishige Kanazawa
Shoji Kubo
author_sort Masahiko Kinoshita
collection DOAJ
description Abstract Background Cholangiocarcinoma due to exposure to 1.2-dichloropropane (DCP) or dichloromethane (DCM) is classified as occupational cholangiocarcinoma. We report a case of occupational cholangiocarcinoma diagnosed 18 years after the end of exposure to organic solvents at a printing company. Case presentation A 41-year-old man presented to our hospital with jaundice and anorexia. He had previously worked for 6 years at a printing company where an outbreak of occupational cholangiocarcinoma occurred and was exposed to high concentrations of organic solvents during his employment. Computed tomography demonstrated lower bile duct obstruction by the bulky nodal metastasis at the hepatoduodenal ligament with upstream biliary dilatation, an intraductal papillary tumor in the dilated left superior lateral bile duct (B2), and enlargement of the periaortic nodes. Clinical diagnosis of an unresectable invasive intraductal papillary neoplasm of the bile duct (IPNB) with extensive nodal metastasis was made. Although chemotherapy and laparoscopic gastrojejunostomy were performed for the duodenal obstruction, the patient died due to rupture of the tumor. Pathological examination of the autopsy specimen revealed well-differentiated adenocarcinoma at the stromal site along Glisson’s sheath in segment 3, an IPNB lesion without invasion in B2, and biliary intraepithelial neoplasia and chronic bile duct injury at various sites in the large bile ducts. The bulky lymph node (poorly differentiated adenocarcinoma with partial squamous cell differentiation) invaded the bile duct and duodenum. Conclusions We report a case of occupational cholangiocarcinoma that developed 18 years after the end of exposure to DCP and DCM. Long-term follow-up is required to carefully survey development of cholangiocarcinoma in workers with an occupational history of exposure to organic solvents.
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spelling doaj-art-1e29ae10e2d446f792a2c6b3f2ea46362025-08-20T03:33:07ZengJapan Surgical SocietySurgical Case Reports2198-77932019-04-01511710.1186/s40792-019-0624-7Occupational cholangiocarcinoma diagnosed 18 years after the end of exposure to 1,2-dichloropropane and dichloromethane at a printing company: a case reportMasahiko Kinoshita0Yasunori Sato1Hiroko Nebiki2Yutaka Tamamori3Naomi Ishii4Takeshi Inoue5Genya Hamano6Akishige Kanazawa7Shoji Kubo8Department of Hepato-Biliary-Pancreatic Surgery, Osaka City General HospitalDepartment of Human Pathology, Kanazawa University Graduate School of MedicineDepartment of Gastroenterology, Osaka City General HospitalDepartment of Gastroenterological Surgery, Osaka City General HospitalDepartment of Pathology, Osaka City General HospitalDepartment of Pathology, Osaka City General HospitalDepartment of Hepato-Biliary-Pancreatic Surgery, Osaka City General HospitalDepartment of Hepato-Biliary-Pancreatic Surgery, Osaka City General HospitalDepartment of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of MedicineAbstract Background Cholangiocarcinoma due to exposure to 1.2-dichloropropane (DCP) or dichloromethane (DCM) is classified as occupational cholangiocarcinoma. We report a case of occupational cholangiocarcinoma diagnosed 18 years after the end of exposure to organic solvents at a printing company. Case presentation A 41-year-old man presented to our hospital with jaundice and anorexia. He had previously worked for 6 years at a printing company where an outbreak of occupational cholangiocarcinoma occurred and was exposed to high concentrations of organic solvents during his employment. Computed tomography demonstrated lower bile duct obstruction by the bulky nodal metastasis at the hepatoduodenal ligament with upstream biliary dilatation, an intraductal papillary tumor in the dilated left superior lateral bile duct (B2), and enlargement of the periaortic nodes. Clinical diagnosis of an unresectable invasive intraductal papillary neoplasm of the bile duct (IPNB) with extensive nodal metastasis was made. Although chemotherapy and laparoscopic gastrojejunostomy were performed for the duodenal obstruction, the patient died due to rupture of the tumor. Pathological examination of the autopsy specimen revealed well-differentiated adenocarcinoma at the stromal site along Glisson’s sheath in segment 3, an IPNB lesion without invasion in B2, and biliary intraepithelial neoplasia and chronic bile duct injury at various sites in the large bile ducts. The bulky lymph node (poorly differentiated adenocarcinoma with partial squamous cell differentiation) invaded the bile duct and duodenum. Conclusions We report a case of occupational cholangiocarcinoma that developed 18 years after the end of exposure to DCP and DCM. Long-term follow-up is required to carefully survey development of cholangiocarcinoma in workers with an occupational history of exposure to organic solvents.http://link.springer.com/article/10.1186/s40792-019-0624-7Occupational cholangiocarcinomaIntraductal papillary neoplasm of the bile ductBiliary intraepithelial neoplasia1,2-DichloropropaneDichloromethane
spellingShingle Masahiko Kinoshita
Yasunori Sato
Hiroko Nebiki
Yutaka Tamamori
Naomi Ishii
Takeshi Inoue
Genya Hamano
Akishige Kanazawa
Shoji Kubo
Occupational cholangiocarcinoma diagnosed 18 years after the end of exposure to 1,2-dichloropropane and dichloromethane at a printing company: a case report
Surgical Case Reports
Occupational cholangiocarcinoma
Intraductal papillary neoplasm of the bile duct
Biliary intraepithelial neoplasia
1,2-Dichloropropane
Dichloromethane
title Occupational cholangiocarcinoma diagnosed 18 years after the end of exposure to 1,2-dichloropropane and dichloromethane at a printing company: a case report
title_full Occupational cholangiocarcinoma diagnosed 18 years after the end of exposure to 1,2-dichloropropane and dichloromethane at a printing company: a case report
title_fullStr Occupational cholangiocarcinoma diagnosed 18 years after the end of exposure to 1,2-dichloropropane and dichloromethane at a printing company: a case report
title_full_unstemmed Occupational cholangiocarcinoma diagnosed 18 years after the end of exposure to 1,2-dichloropropane and dichloromethane at a printing company: a case report
title_short Occupational cholangiocarcinoma diagnosed 18 years after the end of exposure to 1,2-dichloropropane and dichloromethane at a printing company: a case report
title_sort occupational cholangiocarcinoma diagnosed 18 years after the end of exposure to 1 2 dichloropropane and dichloromethane at a printing company a case report
topic Occupational cholangiocarcinoma
Intraductal papillary neoplasm of the bile duct
Biliary intraepithelial neoplasia
1,2-Dichloropropane
Dichloromethane
url http://link.springer.com/article/10.1186/s40792-019-0624-7
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