Ann Hepatobiliary Pancreat Surg.  2016 Nov;20(4):201-203. 10.14701/ahbps.2016.20.4.201.

Cholangiocarcinoma in choledochal cyst after cystoenterostomy: how a mistreated choledochal cyst can progress to malignancy

• Baik H
• Park YH
• Seo SH
• An MS
• Kim KH
• Bae KB
• Choi CS
• Oh SH
• Choi YK

• KMID: 2362472
• DOI: http://doi.org/10.14701/ahbps.2016.20.4.201

Abstract

This case report presents an unusual case of cholangiocarcinoma arising nearly 35 years after cystoduodenostomy for choledochal cyst. The patient visited our hospital with dyspepsia and studies revealed bezoar within the choledochal cyst caused by bile and food reflux. The patient underwent pancreaticoduodenectomy and a biopsy revealed adenocarcinoma, stage IIB. After 19 months, the patient has no recurrence to date and has recovered well. This case shows that proper surgical management and meticulous, long-term follow-up is imperative for patients with congenital choledochal cyst.

Keyword

Choledochal cyst; Cholangiocarcinoma; Pancreaticoduodenectomy

MeSH Terms

Adenocarcinoma
Bezoars
Bile
Biopsy
Cholangiocarcinoma*
Choledochal Cyst*
Dyspepsia
Follow-Up Studies
Humans
Pancreaticoduodenectomy
Recurrence

Figure

• 

  Fig. 1 Imaging studies of the patient. (A) Patient's abdomino-pelvic computed tomogram shows dilatation of intrahepatic duct, pneumobilia, and a 6.8 cm×8.5 cm×5.0 cm-sized bezoar (arrow). (B) Magnetic resonance cholangiopancreaticography also represents cystic dilatation of the extrahepatic bile duct.

• 

  Fig. 2 Microphotographs of the specimen. (A) The common bile duct wall is thickened with tumor invasion and shows extracellular mucin pools (arrow, HE, ×10). (B) Tumor reveals glandular architecture and mucin formation (HE, ×100).

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