A Case of Hilar Bile Duct Carcinoma with Intraductal Papillary Growth arising from Peribiliary Bile Gland of the Left Hepatic Duct

Hidenori Karasaki, Kazunori Watanabe, Daitaro Yoshikawa, Shigetaka Suzuki, Akira Ishizaki, Mituhiro Inagaki, Shuichi Kino, Toru Kono and Shinichi Kasai

Department of Surgery, Division of Gastroenterologic and General Surgery, Asahikawa Medical College

We report a case of a 61-year-old woman with hilar carcinoma arising from the extramural peribiliary gland, a rare origin for biliary malignancy. Computed tomography (CT) showed a solid tumor 15 mm in diameter closely localized to the hepatic hilus. A papillary-growing tumor at the confluence of the hepatic duct was showed by ERC and cholangioscopy. Based on a diagnosis of hepatic duct cancer that may invade the liver forming a solid tumor, we conducted left hepatectomy with extrahepatic bile duct resection. Papillary adenocarcinoma formed a mass within the extramural peribiliary gland of the left hepatic duct and spread the hepatic hilus without obvious invasion into the surrounding parenchyma. It was not easy to identify the origin of the tumor or to discriminate it preoperatively from mass-forming intrahepatic cholangiocarcinoma. Well-circumscribed and spotty enhancement by CT may reflect the nature of papillary and expansive growth tumor.

Key words
mucosal spreading, papillary adenocarcinoma, extramural gland

Reprint requests
Hidenori Karasaki Department of Surgery, Division of Gastroenterologic and General Surgery, Asahikawa Medical College
2-1-1-1 Midorigaoka-Higashi, Asahikawa, 078-8510 JAPAN

Accepted
July 26, 2006

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