A Case of Bile Duct Hamartoma (von Meyenburg complex) which was Difficult to Distinguish from Cholangiocarcinoma; Report of a Case

Hideki Suzuki, Wataru Wada, Kenichiro Araki, Tsutomu Kobayashi, Akihiko Sano, Shinji Sakurai* and Hiroyuki Kuwano

Department of General Surgical Science and Department of Tumor Pathology*, Gunma University

We report the case of a patient with biliary hamartomas, also called von Meyenburg's complex mimicking cholangiocarcinoma. A 58-year's old man reporting a abdominal fullness was found in computed tomography (CT) to have intrahepatic biliary dilation of the left hepatic duct. Drip-infusion cholangiography with computed tomography (DIC-CT) and endoscopic retrograde cholangiopancreatography (ERCP) showed cystic or beaded dilatation-like lesions of the left intrahepatic bile duct and left bile duct stenosis, but no definitive tumor-like lesion. Portogram showed a left poratal vein branch stricture. Based on a diagnosis of hepatic duct cancer possibly invading the liver or portal vein, we conducted left hepatic lobectomy of the liver. Intraoperative frozen sections of the stump of the left bile duct showed no malignancy, so we did not excise any extra bile duct. Histopathologically no malignant cells were seen in the bile duct epithelium, although small cystic lesions were found along the left hepatic duct. The definitive diagnosis was biliary hamartoma (von Meyenburg complex).

Key words
bile duct hamartoma, von Meyenburg complex, cholangiocarcinoma

Reprint requests
Hideki Suzuki Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine
3-39-15 Showa-machi, Maebashi, 371-8511 JAPAN

Accepted
February 18, 2009

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