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Case Reports in Pathology
Volume 2013, Article ID 192458, 5 pages
http://dx.doi.org/10.1155/2013/192458
Case Report

Mucoepidermoid Carcinoma of the Intrapancreatic Common Bile Duct: Immunohistochemical Profile, Prognosis, and Review of the Literature

1Department of Pathology, Jackson Memorial Hospital, University of Miami, Miami, FL 33136, USA
2Department of Pathology, Cleveland Clinic Florida, Weston, FL 33331, USA
3Department of Radiology, Jackson Memorial Hospital, University of Miami, Miami, FL 33136, USA
4Department of Surgery, Jackson Memorial Hospital, University of Miami, Miami, FL 33136, USA
5University of Miami Miller School of Medicine, 1611 NW 12th Avenue, Holtz Center, Room 2042 E, Miami, FL 33136, USA

Received 6 September 2013; Accepted 10 October 2013

Academic Editors: D. Cao, A. Handra-Luca, M. Marino, and I. Meattini

Copyright © 2013 Adrienne E. Moul et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Mucoepidermoid carcinoma of the bile duct is a rare entity. Only one mucoepidermoid carcinoma from the common bile duct has been reported in the Korean literature. Herein, we present the first in the English literature. The tumor arose in the intrapancreatic (distal) common bile duct in an 83-year-old woman who presented with obstructive jaundice and elevated liver enzymes. The tumor invaded the underlying pancreas and peripancreatic adipose tissue and showed pagetoid spread into the extrapancreatic common bile duct and cystic duct. The tumor exhibited nests of malignant cells with diffuse CK7 and MUC1 positivity. The basal cells were p63 and CK5/6 positive. The luminal cells were stained with carcinoembryonic antigen, MUC5, and mucicarmine and were focally positive for CK20. There was focal MUC4 staining on the apical luminal border. The neoplastic cells were negative for MUC2 and HER2-neu. We discuss the clinical presentation, diagnostic features, immunohistochemical profile, and prognosis of mucoepidermoid carcinoma of the common bile duct. The features of this neoplasm are further compared with mucoepidermoid carcinoma of the hepatobiliary system, adenosquamous carcinoma, and mucoepidermoid carcinoma of other organs.