ACASE OF EARLY BILE DUCT CANCER ASSOCIATED KITH CONGENITAL CHOLEDOCHALI CYST AND ANOMALIOUS ARRANGEMENT OF THE PANCREATICOBILIIARY DUCT SYSTEM

Abstract

we experienced a case of early bile duct cancer associated with congenital choledochalcyst and anomalous arrangement of the pancreaticobiliary duct system. The patient wasa51-year-old woman, who was admitted to our hospital due to obstructive jaundice inNovember 19931 Endoscopic retrograde cholangiopancreatography(ERCP)revealed a:nornalous arrangement of the pancreaticobiliary duct system and a congenital choledochal cyst(Alonso-Lej, type I). Percutaneous transhepatic cholangioscopy(PTCS)demonstrated apapillary tumor of Ip type and IIa-like lesions around the main tumor in the bile duct cyst.Histological findings of the biopsied specimens showed papillary adenocarcinoma. Thedepth of invasion was suspected within the fibromuscular layer by endoscpic urtrasonography (EUS)and pancreatoduodenectamy was perfarmed. Pathological examination of theresected specimen revealed a papillary adenocarcinoma in both Ip and IIa-like lesions andthe depth of invasion was within the membranous layer slightly invading the fihromuscularlayer in the cyst wall.