A Case of Asymptomatic Mucin-Producing Intrahepatic Cholangiocarcinoma

Yuichi Otsuka, Tamaki Noie, Munenori Tahara, Yasushi Harihara, Kaoru Furushima, Tetsuo Abe and Toshiro Konishi

Department of Surgery, NTT EC Kanto Medical Center

Mucin-producing intrahepatic cholangiocarcinoma is an uncommon hepatic malignancy that macroscopically secretes mucin within biliary trees, generally resulting in obstructive jaundice and/or cholangitis. An asymptomatic 37-year-old man referred to us with intrahepatic bile duct dilation found in by ultrasonography (US) during a routine physical check up was diagnosed with mucin-producing intrahepatic cholangiocarcinoma based on radiological findings. We conducted extended left hemihepatectomy combined with extrahepatic bile duct resection and lymphadenectomy. Macroscopically, a polypoid lesion 1.8 cm in diameter was found in the dilated bile duct of Couinaud's segment III. Microscopically, the tumor was papillary adenocarcinoma confined within the fibromuscular layer without lymph node metastasis. No lymph node metastasis was seen in cases previously reported in Japan in which tumors remained localized to the mucosal or fibromuscular layer. This suggests the diagnosis of mural inbasion will be helpful in determining the extent of dissection in surgical treatment of this malignancy.

Key words
mucin-producing intrahepatic cholangiocarcinoma, asymptomatic, lymph node metastasis

Reprint requests
Yuichi Otsuka Department of Surgery, NTT EC Kanto Medical Center 5-9-22 Higashigotanda, Shinagawa-ku, Tokyo, 141-8625 JAPAN

Accepted
January 30, 2002

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