A Case of Mucin-Producing Cholangiocarcinoma Diagnosed by Intraductal Ultrasonography and Peroral Cholangioscopy

Yuji Kaneda, Shiro Yogita, Takeshi Yamaguchi, Takayuki Miyauchi, Masashi Kuratate, Seigo Yada, Takahiro Horie*, ZR Qian**, Mitsuyoshi Hirokawa** and Toshiaki Sano**

Department of Surgery and *Gastroenterology, Tokushima Prefectural Miyoshi Hospital
**Department of Pathology I Tokushima University, School of Medicine

We report a case of mucin-producing cholangiocarcinoma in which POCS and IDUS were useful in preoperative diagnosis and treatment selection. A 75-year-old woman with abdominal pain was admitted with a diagnosis of obstructive jaundice. ERCP showed a widely open ampulla of Vater with an extrusion of mucin and mucinous filling defects in a dilated common bile duct. IDUS showed an asymmetrical hyperechoic layer in the bifurcation of the right anterior segmental bile duct, which we believed to be limited to the mucosal layer. We confirmed its location and assessed the longitudinal tumor spread by POCS, diagnosed as adenocarcinoma by brush biopsy. We diagnosed the tumor as mucin-producing cholangiocarcinoma localized to the bifurcation of the right anterior segmental bile duct and the mucosal layer. Histologically, the 15×10 mm tumor remained localized in the mucosal layer. Curative surgery was successful. The patient remains asymptomatic and tumor-free a year and 2 months after surgery.

Key words
mucin-producing cholangiocarcinoma, intraductal ultrasonography, peroral cholangioscopy

Reprint requests
Yuji Kaneda Department of Surgery, Tokushima Prefectural Miyoshi Hospital
815-2 Shima, Ikeda-cho, Miyoshi-gun, Tokushima, 778-0005 JAPAN

Accepted
February 25, 2004

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