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Intrahepatic cholangiocarcinoma arising 34 years after excision of a type IV-A congenital choledochal cyst: Report of a case

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Abstract

We report a rare case of intrahepatic cholangiocarcinoma (IHCC) arising many years after excision of a type IV-A congenital choledochal cyst. A 44-year-old man was transferred to our hospital with acute cholangitis more than 34 years after several operations for congenital biliary dilatation. Imaging showed a huge tumor in the left medial section of the liver, extending to the porta hepatis. Although he had no jaundice, the intrahepatic bile ducts showed cylinder-like dilatation with narrowing of the hilar bile duct. At surgery, the tumor was found to arise from the dilated intrahepatic bile duct just above the narrow portion. He underwent a left hepatic trisectionectomy with a vascular procedure. Microscopically, the tumor was confirmed to be moderate-to-well-differentiated tubular adenocarcinoma. Thus, when the narrow segment is left untouched, careful long-term follow-up is important to detect new lesions at an early stage.

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References

  1. Flanigan DP, Biliary cysts. Ann Surg 1975;182:635–643.

    Article  PubMed  CAS  Google Scholar 

  2. Todani T, Watanabe Y, Toki A, Urushihara N. Carcinoma related to choledochal cysts with internal drainage operations. Surg Gynecol Obstet 1987;164:61–64.

    PubMed  CAS  Google Scholar 

  3. Kobayashi S, Asano T, Yamasaki M, Kenmochi T, Nakagohri T, Ochiai T. Risk of bile duct carcinogenesis after excision of extrahepatic bile ducts in pancreaticobiliary maljunction. Surgery 1999;126:939–944.

    Article  PubMed  CAS  Google Scholar 

  4. Watanabe Y, Toki A, Todani T. Bile duct cancer developed after cyst excision for choledochal cyst. J Hepatobiliary Pancreat Surg 1999;6:207–212.

    Article  PubMed  CAS  Google Scholar 

  5. Chijiiwa K, Tanaka M. Late complications after excisional operation in patients with choledochal cyst. J Am Coll Surg 1994;179:139–144.

    PubMed  CAS  Google Scholar 

  6. Rossi RL, Silverman ML, Braasch JW, Munson JL, Remine SG. Carcinomas arising in cystic conditions of the bile ducts. A clinical and pathologic study. Ann Surg 1987;205:377–384.

    Article  PubMed  CAS  Google Scholar 

  7. Yamaguchi M. Congenital choledochal cyst: Analysis of 1,433 patients in the Japanese literature. Am J Surg 1980;140:653–657.

    Article  PubMed  CAS  Google Scholar 

  8. Nagorney DM, McIlrath DC, Adson MA. Choledochal cysts in adults: clinical management. Surgery 1984;96:656–663.

    PubMed  CAS  Google Scholar 

  9. Masetti R, Antinori A, Coppola R, Coco C, Mattana C, Crucitti A, et al. Choledochocele: changing trends in diagnosis and management. Surg Today 1996;26:281–285.

    Article  PubMed  CAS  Google Scholar 

  10. Kawamoto S, Hiraoka T, Maruta S, Watanabe E, Kanemitsu K, Tsuji T. A case of early cancer in cystic intrahepatic duct associated with congenital choledochal cyst. Hepatogastroenterology 1998;45:428–432.

    PubMed  CAS  Google Scholar 

  11. Yamamoto J, Shimamura Y, Ohtani I, Ohtani H, Yano M, Fukuda K, et al. Bile duct carcinoma arising from the anastomotic site of hepaticojejunostomy after the excision of congenital biliary dilatation: a case report. Surgery 1996;119:476–479.

    Article  PubMed  CAS  Google Scholar 

  12. Goto N, Yasuda I, Uematsu T, Kanemura N, Takai S, Ando K, et al. Intrahepatic cholangiocarcinoma arising 10 years after the excision of congenital extrahepatic biliary dilation. J Gastroenterol 2001;36:856–862.

    Article  PubMed  CAS  Google Scholar 

  13. Suzuki S, Amano K, Harada N, Tanaka S, Hayashi T, Suzuki M, et al. A case of intrahepatic cholangiocarcinoma arising 26 years after excision of congenital biliary dilatation (in Japanese with English abstract). Jpn J Gastroenterol Surg 2004;37:416–421.

    Google Scholar 

  14. Todani T, Watanabe Y, Toki A, Urushihara N, Sato Y. Reoperation for congenital choledochal cyst. Ann Surg 1988;207:142–147.

    Article  PubMed  CAS  Google Scholar 

  15. Fujisaki S, Akiyama T, Miyake H, Amano S, Tomita R, Fukuzawa M, et al. A case of carcinoma associated with the remained intrapancreatic biliary tract 17 years after the primary excision of a choledochal cyst. Hepatogastroenterology 1999;46:1655–1659.

    PubMed  CAS  Google Scholar 

  16. Chaudhuri PK, Chaudhuri B, Schuler JJ, Nyhus LM. Carcinoma associated with congenital cystic dilation of bile ducts. Arch Surg 1982;117:1349–1351.

    PubMed  CAS  Google Scholar 

  17. Cohen GP, O’Donnell C. Malignant change within surgically drained choledochal cysts. Australas Radiol 1992;36:219–221.

    Article  PubMed  CAS  Google Scholar 

  18. Scudamore CH, Hemming AW, Teare JP, Fache JS, Erb SR, Watkinson AF. Surgical management of choledochal cysts. Am J Surg 1994;167:497–500.

    Article  PubMed  CAS  Google Scholar 

  19. Chijiiwa K, Komura M, Kameoka N. Postoperative follow-up of patients with type IVA choledochal cysts after excision of extrahepatic cyst. J Am Coll Surg 1994;179:641–645.

    PubMed  CAS  Google Scholar 

  20. Strong R. Type IVA choledochal cyst: is hepatic resection necessary? HPB Surg 1996;10:61–63.

    Article  PubMed  CAS  Google Scholar 

  21. Gallagher PJ, Millis RR, Mitchinson MJ. Congenital dilatation of the intrahepatic bile ducts with cholangiocarcinoma. J Clin Pathol 1972;25:804–808.

    Article  PubMed  CAS  Google Scholar 

  22. Joseph VT. Surgical techniques and long-term results in the treatment of choledochal cyst. J Pediatr Surg 1990;25:782–787.

    Article  PubMed  CAS  Google Scholar 

  23. Yoshikawa K, Yoshida K, Shirai Y, Sato N, Kashima Y, Coutinho DS, et al. A case of carcinoma arising in the intrapancreatic terminal choledochus 12 years after primary excision of a giant choledochal cyst. Am J Gastroenterol 1986;81:378–384.

    PubMed  CAS  Google Scholar 

  24. Todani T, Watanabe Y, Fujii T, Toki A, Uemura S, Koike Y. Congenital choledochal cyst with intrahepatic involvement. Arch Surg 1984;119:1038–1043.

    PubMed  CAS  Google Scholar 

  25. Strong RW. Late bile duct cancer complicating biliary-enteric anastomosis for benign disease. Am J Surg 1999;177:472–474.

    Article  PubMed  CAS  Google Scholar 

  26. Tocchi A, Mazzoni G, Liotta G, Lepre L, Cassini D, Miccini M. Late development of bile duct cancer in patients who had biliaryenteric drainage for benign disease: a follow-up study of more than 1,000 patients. Ann Surg 2001;234:210–214.

    Article  PubMed  CAS  Google Scholar 

  27. Neuhaus P, Jonas S, Bechstein WO, Lohmann R, Radke C, Kling N, et al. Extended resections for hilar cholangiocarcinoma. Ann Surg 1999;230:808–819.

    Article  PubMed  CAS  Google Scholar 

  28. Ebata T, Nagino M, Kamiya J, Uesaka K, Nagasaka T, Nimura Y. Hepatectomy with portal vein resection for hilar cholangiocarcinoma: audit of 52 consecutive cases. Ann Surg 2003;238:720–727.

    Article  PubMed  Google Scholar 

  29. Kondo S, Hirano S, Ambo Y, Tanaka E, Okushiba S, Morikawa T, et al. Forty consecutive resections of hilar cholangiocarcinoma with no postoperative mortality and no positive ductal margins: results of a prospective study. Ann Surg 2004;240:95–101.

    Article  PubMed  Google Scholar 

  30. Hemming AW, Reed AI, Fujita S, Foley DP, Howard RJ. Surgical management of hilar cholangiocarcinoma. Ann Surg 2005;241:693–699.

    Article  PubMed  Google Scholar 

  31. Kurosawa H, Kimura F, Ito H, Shimizu H, Togawa A, Otsuka M, et al. Right hepatectomy combined with retrohepatic caval resection, using a left renal vein patch graft for advanced cholangiocarcinoma. J Hepatobiliary Pancreat Surg 2004;11:362–365

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Digestive and General Surgery, Department of Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan

    Kazuhiko Shimamura, Isao Kurosaki, Daisuke Sato, Kabuto Takano, Yoshinobu Sato & Katsuyoshi Hatakeyama

  2. Department of Surgery, Niigata City General Hospital, Niigata, Japan

    Naoyuki Yokoyama

  3. Department of Surgery, Kameda Daiichi Hospital, Kameda, Niigata, Japan

    Keiko Nakadaira

  4. Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan

    Minoru Yagi

Authors
  1. Kazuhiko Shimamura
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  2. Isao Kurosaki
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  3. Daisuke Sato
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  4. Kabuto Takano
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  5. Naoyuki Yokoyama
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  6. Yoshinobu Sato
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  7. Katsuyoshi Hatakeyama
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  8. Keiko Nakadaira
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  9. Minoru Yagi
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Shimamura, K., Kurosaki, I., Sato, D. et al. Intrahepatic cholangiocarcinoma arising 34 years after excision of a type IV-A congenital choledochal cyst: Report of a case. Surg Today 39, 247–251 (2009). https://doi.org/10.1007/s00595-008-3825-4

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  • DOI: https://doi.org/10.1007/s00595-008-3825-4

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