A case of primary biliary cirrhosis associated with a colon cancer

Abstract

We report a case of primary biliary cirrhosis (PBC) associated with colon cancer. A 58-year-old woman referred for general malaise and icterus was found in laboratory studies to have high serum biliary enzymes. HBS antigen and HCV antibody were negative. Antimitochondrial antibody was positive. She was diagnosed as having PBC. Colonoscopy and barium enema were done for general evaluation. Biopsy of a tumor detected in the sigmoid colon showed adenocarcinoma. Hepatic impairment normalized after medication was started. Sigmoidectomy with D2 lymph node dissection and liver biopsy were done, and the postoperative course was uneventful. Macroscopically, the 40 × 37 mm type 3 tumor was located in the sigmoid colon. Histopathologically, the tumor was moderately differentiated adenocarcinoma with invasion to the subserosal connective tissue. No node involvement was seen. The histological stage was II. Histological features on liver biopsy indicated stage 2 according to Scheuer's classification. Patients with PBC sometimes have extrahepatic malignant tumors. Reports of colorectal cancer coexisting with PBC are few. We review similar cases in the Japanese literature. Patients with PBC should be examined carefully for extrahepatic malignancies, including the gastrointestinal tract, in diagnosis and follow-up.