Abstract
A 64-year-old-man who had a previous history of ascending colon and left renal pelvic cancers was found to have dilation of an intrahepatic duct at another hospital in 2008. He was referred to our hospital for further examination and treatment of rectal and gastric cancers in June 2010. No marked change in the degree of intrahepatic biliary dilation was shown on CT, and biopsy under the endoscopic retrograde cholangiography revealed no malignancy, so we decided to observe the biliary tract tumor carefully. Tumor growth was shown on CT after one year, and he underwent left hepatic and caudate lobectomy with a preoperative diagnosis of IPNB in May 2011. Histopathologically, the tumor extended from the left hepatic duct to the whole of the lateral segment, and papillary tumor was seen around the bifurcation of the hepatic duct. Slight tumor invasion into the wall of the bile duct was found. The tumor was considered to be slow-growing and low-grade, because of the long clinical course.
In this case, it was important to consider the possibility of Lynch syndrome based on the past medical and family history. We need to think of the possibility of IPNB and consider the indications or resection when localized intrahepatic biliary dilation and papillary tumor are seen.
