Abstract
A case of primary carcinoma of the cystic duct based on Farrar's criteria is reported. An 83-year-old woman complained of fever. Ultrasonography showed swelling of the gall bladder. Endoscopic retrograde cholangiopancreatography demonstrated that the cystic duct and gall bladder were not opacified. Tumor of the cystic duct could not be ruled out on MRI. Percutaneous transhepatic cholecystgram showed dilated gall bladder without gall stone and complete occlusion of the cystic duct. Laparoscopic cholecystectomy was performed under a preoperative diagnosis of cholecystitis because of complete occlusion of the cystic duct. Tumor measuring 17 × 15mm was detected in the cystic duct. Dissection of the regional lymph nodes was added because malignancy could not be ruled out. Histologically the tumor was a papillary adenocarcinoma. The depth of tumor invasion is limited to the subserosal layer. The resected specimen revealed no evidence of malignancy in the wall of the remnant cystic duct. As of 17 months after the operation, her clinical course is good and there has been no evidence of recurrence.
