A Case of Mucin Producing Cholangiocarcinoma Associated with a Congenital Choledochal Cyst

Takahiro Tsuchikawa¹⁾²⁾, Tatsunosuke Ichimura¹⁾²⁾, Shigeki Abeshima¹⁾²⁾, Naoto Hasegawa¹⁾, Noriaki Kanno¹⁾, Yutaka Moriyama¹⁾, Makoto Kawabata¹⁾, Tetsuo Hamano¹⁾, Satoshi Kondo²⁾ and Hiroyuki Katoh²⁾

¹⁾Department of Surgery, Kushiro City General Hospital
²⁾Department of Surgical Oncology, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine

A 63-year-old woman reporting left upper quadrant abdominal pain and admitted under diagnosis of cholangitis was found in abdominal computed tomography (CT) to have an atrophied right hepatic lobe and a dilated intrahepatic bile duct. Percutaneous transhepatic cholangio drainage (PTCD) removed a large amount of mucin-like material. CT and cholangiography findings suggested a mucin-producing lesion in the right hepatic duct with a congenital choledochal cyst involving both intra-and extrahepatic ducts. Right hepatectomy with resection of the common bile duct and left hepatico jejunostomy (Roux-en-Y) was done. Macroscopic findings showed a 5.5×4 cm IIa tumor from the bifurcation to the right hepatic duct. Histopathologically, the tumor was well differentiated adenocarcinoma in the mucosa without lymph node metastasis or invasion of the surrounding tissues. The patient remains alive and well in the 27 months postoperatively without sign of reccurrence.

Key words
mucin producing cholangiocarcinoma, congenital choledochal cyst, cholangitis

Reprint requests
Takahiro Tsuchikawa Department of Surgery, Kushiro City General Hospital
1-12 Syunkodai, Kushiro, 085-0822 JAPAN

Accepted
June 30, 2004

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