A Case of Hilar Bile Duct Carcinoma with Intraductal Papillary Growth arising from Peribiliary Bile Gland of the Left Hepatic Duct

Abstract

We report a case of a 61-year-old woman with hilar carcinoma arising from the extramural peribiliary gland, a rare origin for biliary malignancy. Computed tomography (CT) showed a solid tumor 15mm in diameter closely localized to the hepatic hilus. A papillary-growing tumor at the confluence of the hepatic duct was showed by ERC and cholangioscopy. Based on a diagnosis of hepatic duct cancer that may invade the liverforming a solid tumor, we conducted left hepatectomy with extrahepatic bile duct resection. Papillary adenocarcinoma ormed a mass within the extramural peribiliary gland of the left hepatic duct and spread the hepatic ilus without obvious invasion into the surrounding parenchyma. It was not easy to identify the origin of the tumor or to discriminate it preoperatively from mass-forming intrahepatic cholangiocarcinoma. Wellcircumscribed nd spotty enhancement by CT may reflect the nature of papillary and expansive growth tumor.