Curative Simple Resection of Primary Biliary Cystadenocarcinoma of the Liver -A Case Report-

Noriyuki Hirahara, Haruhiko Nagami, Shoichiro Sumi, Yoshinori Nio, Katsuhiro Tamura

First Department of Surgery, Shimane Medical University

A case of primary biliary cystadenocarcinomas is reported. Although its preoperative diagnosis is usually difficult. This case was correctly diagnosed before operation. In this case, simple resection of the cyst was considered to be sufficiently curative, since it was isolated from intrahepatic bile duct. A 66-year-old woman was introduced to our clinic for examination of liver dysfunction' Abdominal ultrasonography, computed tomography and magnetic resonance imaging demonstrated large, solitary, multilocular lesion in the liver, which was shown to be hypervascular in the marginal portion of the lesion by angiography. Laparoscopic aspiration biopsy did not show any malignant cells, but elevated CEA (135 ng/ml) and CA19-9 (146 U/ml) in the cyst fluid suggested that it was a primary biliary cystadenocarcinoma. Resection of the cyst was performed for therapy. Histological examination demonstrated that the cyst wall consisted of a mucin-producing papillary adenocarcinoma and the solid tumor consisted of poorly differentiated adenocarcinoma with partial necrosis. The prognosis of biliary cystadenocarcinoma after surgery is usually better than that of hepatocellular carcinoma or cholangiocarcinoma, and the surgical resection is the first choice for therapy.

Key words
cystadenocarcinom, liver, simple resection of the cyst

Reprint requests
Noriyuki Hirahara First Department of Surgery, Shimane Medical University
89-1 Enya-cho, Izumo, 693 JAPAN

Accepted
March 8, 1995

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