Primary Carcinoma of the Cystic Duct: Report of Four Cases

Hiroshi Sugiura,Hiroshi Takahashi,Eiji Shimozawa,Akira Fukunaga,Ryunosuke Hase and Hiroyuki Katoh^*

Department of Surgery, Hakodate Medical Association Hospital ^*, Department of Surgical Oncology, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine

We report herein four patients with primary carcinoma of the cystic duct. Case 1: A 70-year-old male underwent a cholecystectomy under the diagnosis of cholecystolithiasis. A histopathological examination revealed a tubular adenocarcinoma infiltrating the fibromuscular layer of the cystic duct. Resection of the bile duct was therefore performed. Nine years after the operation, he died as a result of a cerebral infarction. The carcinoma did not recur. Case 2: A 61-year-old male presented with jaundice. ERCP demonstrated the stenosis of the middle bile duct and an obstruction of the cystic duct. He underwent an extended cholecystectomy and resection of the bile duct. A histopathological examination revealed an adenocarcinoma of the cystic duct, with ductal spread to the bile duct. He is alive and shows no signs of recurrence 112 months after the operation. Case 3: A 54-year-old male was admitted with acute cholecystitis. Percutaneous transhepatic cholangiography showed an obstruction of the cystic duct. An ERCP-assisted biopsy revealed a tubular adenocarcinoma. He underwent an extended cholecystectomy and resection of the bile duct. Microscopically, the carcinoma infiltrated the subserosal layer of the cystic duct, with perineural invasion and ductal spread to the bile duct. Sixteen months after the operation, he died of pleuritis carcinomatosis. Case 4: A 70-year-old female presented with abdominal pain. CT demonstrated a tumor of the cystic duct. An ERCP-assisted biopsy revealed a tubular adenocarcinoma. She underwent an extended cholecystectomy and resection of the bile duct and is alive with no signs of recurrence one year after the operation.

Key words
carcinoma of cystic duct, gallbladder

Reprint requests
Hiroshi Sugiura Department of Surgery, Hakodate Medical Association Hospital 2-10-10 Tomioka-cho, Hakodate, 041-8522 JAPAN

Accepted
July 30, 2001

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