Cholangiocarcinoma Associated with Hepatolithiasis

Motomichi Sato, Yoshihito Abe, Toshihisa Lee, Jun Horiuchi, Jun Masuda, Shigeru Kimura

Second Department of Surgery, Ehime University, School of Medicine

Four cases of hepatolithiasis complicated by cholangiocarcinoma are reported. Three patients had preceding symptoms caused by hepatolithiasis, the average duration of which was 8.7 years. In 3 patients, the main part of the tumor and the stones were located in the same side of the liver. The gross appearance of the tumor were divided: massive type in 2 cases, diffuse type in 1 case and nodular type in 1 case. Regional invasion of the tumor were observed in 2 cases; hilar invasion in 3 cases; periductal invasion in 3 cases and lymph node metastasis in 2 cases. Two patients underwent hepatic resection, one of which was a curative one. One patient with cystadenocarcinoma is alive 4 years post-operatively. The prognosis of another 3 patients, who had extended tumors, was quite poor. Histologically these tumor were differenciated adenocarcinoma. Proliferative cholangitis and dysplasia of the epithelium were observed in the dilated intrahepatic bile ducts apart from the tumors; these may be malignant changes leading to the development of cholangiocarcinoma.

Key words
hepatolithiasis, cholangiocarcinoma, proliferative cholangitis

Reprint requests
Motomichi Sato Second Department of Surgery, Ehime University Medical School
29 Shitsukawa, Shigenobu-cho, Onsen-gun, Ehime, 791-02 JAPAN

Accepted
December 12, 1990

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