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Int J Clin Exp Pathol 1(2):147-156;2008

Original Article
Adenosquamous Carcinoma of Extrahepatic Bile Duct: Clinicopathologic Study of 12

Seung-Mo Hong, Mi-Jung Kim, Kee-Taek Jang, Ghil-Suk Yoon, HyungJun Cho, Henry F. Frierson Jr. and Eunsil Yu

Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD;  Asan Medical Center, University of Ulsan College of Medicine,
Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Kyungpook National University Hospital,
Daegu, Korea, Department of Statistics and Biostatistics, Korea University, Seoul, Korea, and Department of Pathology, University of Virginia
Health System, Charlottesville, VA.

Received 2 Aug 2007; accepted and available online 1 January 2008

Abstract: Adenosquamous carcinoma is a rare histologic subtype of extrahepatic bile duct (EBD) carcinoma and limited information is
available on its clinicopathologic characteristics. Twelve cases of adenosquamous carcinoma were collected from 3 institutions and their
clinicopathologic characteristics were examined and compared with those of 176 EBD adenocarcinomas. The adenocarcinoma component
was more often seen at the surface of the tumor (7 of 12 cases, 58%), while the squamous carcinoma component was slightly more frequent
at the advanced edge (7 of 12 cases, 58%). Immunohistochemistry, available in 10 cases, revealed that S100A2 was positive in the squamous
carcinoma component in all 10 cases (100%), while it was present in the adenocarcinoma component in only 2 of 10 cases (20%, chi-square
test, p=0.001). S100A4 expression did not show any difference between the two components. Patients with adenosquamous carcinomas had
worse survival (median survival, 11 months) than those with adenocarcinoma (median survival, 32 months; log-rank test, p=0.003). Patients
with predominant squamous cell carcinoma component at the leading edge had worse survival than those without it. In conclusion, patients
with adenosquamous carcinoma demonstrated worse survival than those with pure adenocarcinoma. S100A2 immunohistochemical staining
may be helpful in detecting the squamous component. (IJCEP708005).

Key Words: Adenosquamous carcinoma, extrahepatic bile duct, cholangiocarcinoma, S100A2, prognosis

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Address all correspondence to: Seung-Mo Hong, MD, PhD, Department of Pathology, Johns Hopkins Medical Institutions, 1550 Orleans
Street, CRB 2, Suite 3M41, Baltimore, MD, 21209; Tel: 410-955-3511; Fax: 410-614-0671; E-mail: