Clin Endosc.  2012 Nov;45(4):435-439.

One Case of Common Bile Duct Cancer Mimicking Cystic Neoplasm of the Pancreas, Arising 9 Years after Excision of a Choledochal Cyst

• Park SW
• Lee SH
• Eum YO
• Oh HS
• Lee D
• Jin E
• Chung K
• Hwang JH

Abstract

A 42-years-old woman had undergone operation for cholecochal cyst with gallbladder cancer 9 years ago. Pathology revealed a polypoid mass in the gallbladder with liver infiltration as poorly differentiated adenocarcinoma. Computed tomography, magnetic resonance cholangiopancreatography, and endoscopic ultrasound showed a newly developed suspected solid nodule in the peripheral portion of cystic lesion in the pancreas head. She underwent a pylorus preserving pancreaticoduodenectomy for the suspected mucinous cystic neoplasm of the pancreas. Pathology revealed poorly differentiated adenocarcinoma. The remnant choledochal cyst had developed to cholangiocarcinoma, which mimicked cystic neoplasm of the pancreas.

Keyword

Choledochal cyst; Pancreatic cyst; Cholangiocarcinoma

MeSH Terms

Adenocarcinoma
Cholangiocarcinoma
Cholangiopancreatography, Magnetic Resonance
Choledochal Cyst
Common Bile Duct
Female
Gallbladder
Gallbladder Neoplasms
Head
Humans
Liver
Mucins
Pancreas
Pancreatic Cyst
Pancreaticoduodenectomy
Pylorus
Mucins

Figure

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  Fig. 1 (A) Enhanced computed tomography showed solid nodule in the peripheral portion of cystic lesion, 5 cm in diameter, in the pancreas head (axial view). (B) Coronal view.

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  Fig. 2 (A) Magnetic resonance cholangiopancreatography representing cystic lesion in the pancreatic head, (B) a tiny solid nodule in the cystic lesion (white arrow).

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  Fig. 3 Endoscopic ultrasound showed 5 cm diameter cystic lesion in pancreatic head, thick cystic wall, and multiple mural nodules in the cystic lesion (white arrow).

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  Fig. 4 Microscopic finding. (A) Polypoid nodule, invaded to the perimuscular connective tissue of pancreas. Acinar structure of pancreas was seen beneath the nodule. (B) Moderately to poorly diffrentiated adenocarcinoma surrounded by desmoplastic reaction (H & E stain, ×100).

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