A Case of Early Intrahepatic Cholangiocarcinoma with Intraductal Papillary Growth

Shinji Mitsue, Gen Tanabe, Kouichi Kawaida, Yasuyuki Kobayashi, Shinichi Ueno, Takashi Aikou

First Department of Surgery, Kagoshima University School of Medicine

A 66-year-o1d man presented with early intrahepatic cholangiocarcinoma with intraductal papillary growth. Abdominal US showed a high echogenic mass in the left hepatic duct. The left lobe, the caudate lobe and the left hepatic duct were resected. The tumor showed expansive growth in the left hepatic duct without invasion to the parenchyma of the liver. Histologically, the tumor showed various structual atypia with little mucin production, and was limited to the mucosa. Immunohistologically, intestinal-type apomucin was expressed in this tumor, but mammary-type was not. We diagnosed this tumor as an early intraductal papillary cholangiocarcinoma. The patient is doing well without the evidence of recurrence 50 months after surgery. Seven cases of intraductal cholangiocarcinoma including our case have been reported in the Japanese literatures. All the tumors except ours have been reported as mucin-producing cholangiocarcinomas. Patients with intraductal papillary cholangiocarcinoma which is limited to the mucosa of fibromuscular layer could be given a good prognosis by surgery.

Key words
intraductal papillary cholangiocarcinoma, early intrahepatic cholangiocarcinoma, intestinal and mammary type apomucins

Reprint requests
Shinji Mitsue First Department of Surgery, Kagoshima University School of Medicine
8-35-1 Sakuragaoka, Kagoshima, 890 JAPAN

Accepted
March 8, 1995

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