An Adult Case of Type II Congenital Choledochal Cyst with Early Bile Duct Carcinoma

Shinji Otani, Kimiyasu Nozaka*, Nobuhiko Toyota*, Toshiro Wakatsuki*, Masataka Takebayashi*, Akira Kamasako*, Osamu Tanida* and Kei Kato**

Department of Surgery, Hino Hospital
Department of Surgery* and Department of Pathology**, San-in Rosai Hospital

A 58 year-old woman with a gallbladder polyp was eventually diagnosed after hospital admission with having a congenital choledochal cyst with a bile duct tumor, although no pancreaticobiliary maljunction was detected. We resected the bile duct with the choledochal cyst and undertook Roux-en-Y reconstruction. The bile duct formed a diverticulum 6 cm at the greatest dimension from the hepatic duct, and fibrosis and inflammatory cell invasion were found histologically. The tumor was found to be papillary carcinoma limited to mucosa without lymph node metastasis. Such type II choledochal cyst with early bile duct carcinoma is extremely rare. Exposure to pancreatic juice is thought to be a cause of bile duct cancer, but this was hard to conclude in this case.

Key words
congenital choledochal cyst, Alonso-Lej type II, bile duct carcinoma

Reprint requests
Shinji Otani Department of Surgery, Hino Hospital
332 Nota, Hino-cho, Hino-gun, 689-4504 JAPAN

Accepted
July 26, 2006

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