A Case of Carcinoma in the Mucosal Layer of the Bile Duct without Jaundice

Yoshito Kuroki, Syunyou Otagiri, Takashi Sakamoto^* and Kazuhiro Tsukada^*

Department of Surgery, Kamioka Town Hospital, ^*Second Department of Surgery, Toyama Medical and Pharmaceutical University

A diagnosis of bile duct carcinoma is difficult to make in the early stage before the onset of jaundice. We report here, a patient with carcinoma in the mucosal layer of the bile duct, who was without jaundice, and who was diagnosed in the early stage. The patient was a 72-year-old woman who was admitted to our hospital because of a burn that occurred in her home. She exhibited liver dysfunction (elevation of GOT, GPT, ALP and γ -GTP) but without jaundice. Ultrasonography and computed tomography showed dilatation of the bile duct and a mass in the lower third portion of the extrahepatic bile duct. Endoscopic retrograde cholangiography revealed a 4.5 cm filling defect in the bile duct, and magnetic resonance cholangiography showed similar findings. Subsequently, pylorus-preserving pancreato-duodenectomy was performed. Pathological analysis revealed 2 papillary tumors (12× 12 mm, and 18× 9 mm in size) in the bile duct, which were characterized as papillary adenocarcinoma located in the mucosal layer with no lymph node metastasis (Bi, pap, m, hinf₀, ginf₀, panc₀, du₀, pv₀, a₀, n (-), stage I). The patient has been well for 17 months after surgery without recurrence.

Key words
early bile duct carcinoma, no jaundice of bile duct carcinoma, papillary adenocarcinoma of bile duct

Reprint requests
Yoshito Kuroki Department of Surgery, Kamioka Town Hospital 725 Higashi-machi, Kamioka Town, Gifu, 506-1111 JAPAN

Accepted
December 9, 1998

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