Synchronous double cancer of the common bile duct.

Synchronous double cancer of the common bile duct is exceptional and only one reported case was found in the literature. We report a case in which the diagnosis of the double tumor was missed by computed tomography scan, magnetic resonance imaging, and endoscopic ultrasonography. The diagnosis of the distal tumor was made only during surgery. There was no communication in either the mucosal layer or the subepithelial layer between the 2 cancers without periductal lymphatic spread, thus suggesting that they are primary. 2011 Elsevier Inc. All rights reserved.