1999 Volume 32 Issue 5 Pages 1217-1221
A diagnosis of bile duct carcinoma is difficult to make in the early stage before the onset of jaundice. We report here, a patient with carcinoma in the mucosal layer of the bile duct, who was without jaundice, and who was diagnosed in the early stage. The patient was a 72-year-old woman who was admitted to our hospital because of a burn that occurred in her home. She exhibited liver dysfunction (elevation of GOT, GPT, ALP andγ-GTP) but without jaundice. Ultrasonography and computed tomography showed dilatation of the bile duct and a mass in the lower third portion of the extrahepatic bile duct. Endoscopic retrograde cholangiography revealed a 4.5 cm filling defect in the bile duct, and magnetic resonance cholangiography showed similar findings. Subsequently, pylorus-preserving pancreato-duodenectomy was performed. Pathological analysis revealed 2 papillary tumors (12×12 mm, and 18×9 mm in size) in the bile duct, which were characterized as papillary adenocarcinoma located in the mucosal layer with no lymph node metastasis (Bi, pap, m, hinf0, ginf0, panc0, du0, pv0, a0, n (-), stage I). The patient has been well for 17 months after surgery without recurrence.
