A Case of Mucin-Producing Cholangiocarcinoma with Mucosal Invasion without Preoperatively Any Evidence of Tumor, Resembling Intraductal Papillary Mucinous Tumor of the Pancreas

Masashi Hirota, Tetsuya Kaneko, Shigehiro Kure, Hiroyuki Sugimoto, Soichiro Inoue, Shin Takeda and Akimasa Nakao

Department Gastroenterological Surgery, Nagoya University Graduate School of Medicine

A 62-year-old man with epigastric pain who was found to have dilatation of the left intrahepatic bile duct by a local physician was admitted to our hospital. Laboratory data showed biliary congestion. Abdominal enhanced CT showed dilatation of the left intrahepatic and extrahepatic bile ducts without any evidence of tumor. ERCP showed mucin-like massive filling defects in the dilated common hepatic duct and an amorphous defect in the left intrahepatic bile duct. Intraductal ultrasonography showed no evidence of a mass lesion of the bile ducts. These findings suggested mucin-producing cholangiocarcinoma in the left intrahepatic bile duct, and he was treated by left lobectomy, including the left caudate lobectomy. The resected specimen showed a 2.5×1 cm papillary mass in the proximal portion of the intrahepatic bile duct of segment 3. Histopathological examination showed that the tumor consisted of mucin-secreting papillary adenocarcinoma localized to the mucosal layer and an adenoma component. Clinicopathologically the tumor resembled an intraductal papillary mucinous tumor of the pancreas. We report the case of mucin-producing cholangiocarcinoma based on recent view points regarding terminology and classification.

Key words
mucin-producing cholangiocarcinoma, intraductal papillary mucinous tumor of the pancreas, mucosal invasion

Reprint requests
Masashi Hirota Department of Surgery, National Hospital Organization Toyohashi Medical Center
50 Hamamichigami, Imure-cho, Toyohashi, 440-8510 JAPAN

Accepted
March 30, 2005

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