Bile duct carcinoma following abdominal radiation for urologic neoplasms

This report concerns three cases of bile duct carcinoma which occurred 15–40 years after patients received treatment for urogenital neoplasia. All three patients had initially received radiation therapy in addition to urological surgery. Jaundice was the major clinical symptom of the second tumor. Two of the three patients were able to be surgically treated when presenting with their second carcinoma (partial pancreaticoduodenectomy, bile duct resection; central liver resection), whereas the third patient was in such a poor state of health that he was biopsied only and treated with a pigtail drain. All three patients died within 3 months to 3 years following the diagnosis of the second tumor. The more than coincidential occurrence of the rare bile duct carcinoma in our three patients with previous urogenital neoplasia warrants a new discussion concerning the connection between primary carcinoma, radiation therapy, and the occurrence of a second tumor.