A Case of Mucin Producing Cholangiocarcinoma Associated with a Congenital Choledochal Cyst

Abstract

A 63-year-old woman reporting left upper quadrant abdominal pain and admitted under diagnosis of cholangitis was found in abdominal computed tomography (CT) to have an atrophied right hepatic lobe and a dilated intrahepatic bile duct. Percutaneous transhepatic cholangio drainage (PTCD) removed a large amount of mucin-like material. CT and cholangiography findings suggested a mucin-producing lesion in the right hepatic duct with a congenital choledochal cyst involving both intra-and extrahepatic ducts. Right hepatectomy with resection of the common bile duct and left hepatico jejunostomy (Roux-en-Y) was done. Macroscopic findings showed a 5.5×4 cm IIa tumor from the bifurcation to the right hepatic duct. Histopathologically, the tumor was well differentiated adenocarcinoma in the mucosa without lymph node metastasis or invasion of the surrounding tissues. The patient remains alive and well in the 27 months postoperatively without sign of reccurrence.