A Resected Case of Cholangiocellular Carcinoma of the Caudate Lobe with Intraluminal Growth into the Extrahepatic Bile Duct

Yuichi Machiki, Hidetaka Shigeta, Tetsuo Takayama*, Yuzo Sakai*, Satoshi Kondo**

Department of Surgery, and Department of Internal Medicine*, Sakashita Hospital
**Department of Surgery, Kasugai Municipal Hospital

A case of cholangiocellular carcinoma in the caudate lobe with intraluminal growth in the extrahepatic bile duct is reported. A 65-year-old woman presenting with obstructive jaundice was hospitalized and underwent percutaneous transhepatic biliary drainage (PTBD). Cholangiography through the PTBD catheter revealed a filling defect at the hepatic hilus. The right hepatic duct and the right caudate branch were not visible. Abdominal CT showed a mass about 3 cm in diameter in the right caudate lobe and a low-density mass in the bile duct at the hepatic hilus. Percutaneous transhepatic cholangioscopy (PTCS) demonstrated a pinkish tumor with a nodular surface in the bile duct. Cholangioscopic biopsy revealed adenocarcinoma. Right hepatic lobectomy and caudate lobectomy with bile duct resection were performed. Cholangiocellular carcinoma in the caudate lobe with intraluminal growth in the extrahepatic bile duct is extremely rare and only a few cases have been reported. Endoscopic findings and biopsy under PTCS proved very useful for differential diagnosis between hepatocellular carcinoma and cholangiocellular carcinoma. To identify the location, the range, and the type of the main tumor and the intraluminal tumor is important for deciding on the operative procedure.

Key words
cholangiocellular carcinoma, caudate lobe, intraluminal growth in the blle duct

Reprint requests
Yuichi Machiki Department of Surgery, Kiryu Kosei Hospital
6-3 Orihime-cho, Kiryu, 376-0024 JAPAN

Accepted
January 14, 1998

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