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A Case of Carcinoma in Congenital Choledochal Cyst T. Tsurumi 1 , H. Harada 1 , K. Matsuo 1 , Y. Tomiyama 1 , H. Mandai 1 12nd Dept. of Internal Medicine, Faculty of Medicine, Okayama University pp.1183-1186
Published Date 1976/9/25
DOI https://doi.org/10.11477/mf.1403107431
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 This report is concerned with a case of congenital choledochal cyst complicated by the occurrence of cancer six years after cystoduodenal anastomosis which was diagnosed by duodenofiberscopy and endoscopic retrograde cholangiography.

 Symptoms were characterized by general malaise, weight loss and recurrent attacks of colicky pain in the epigastrium, anorexia, and fever which were relieved only transiently by medical treatment.

 Pneumobilia was noted on a plain film of the abdomen. Intravenous cholantiography failed to reveal the biliary tract. Endoscopic observation revealed irregularity and hemorrhage on the margin of the orifice of the choledochal cyst-duodenal anastomosis.

 Endoscopic retrograde cholangiography showed a cystic dilatation of the common bile duct with a stenosis in the most distal segment and multiple irregular shadow defect in the common bile duct. Biopsy obtained from the cyst disclosed papillary adenocarcinoma.

 This case belongs to the type I, congenital cystic dilatation of the common duct, according to the clas-sification made by Alonso-Lej (1959).

 Operative findings: The common bile duct was buried in the surrounding tissue invaded by the malignat lesion forming a large mass.

 Resection of the malignant lesion could not be performed. Kasai et al. reported a review on 15 cases of choledochal cyst complicated by the occurence of cancer. It was disclosed that in 5 of these 15 cases cystointestinal anastomosis had been performed before the presence of the malignant lesion was diagnosed.

 These 5 cases and our experience indicate that resection of the cyst should be preferably performed for the surgical treatment of the choledochal cyst.


Copyright © 1976, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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