RESECTED CASE OF MUCINOUS CYSTADENOCARCINOMA OF THE BILE DUCT

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This paper presents a patient with mucinous cystadenocarcinoma of the bile duct, who was able to undergo radical operation after the extension of the cancer invasion was preoperatively diagnosed by percutaneous transhepatic cholangioscopy (PTCS), with a review of the literature. A 57-year-old woman was admitted to the hospital because of heart burn and general fatigue. On admission, alkaline phosphatase activity was 12.6 KAU, leucine aminopeptidase was 26mu/ml, carcinoembryonic antigen was 7.9ng/ml, and carbohydrate antigen CA19-9 was 71U/ml. Computed tomography and abdominal ultrasonography visualized dilation of the common bile duct and intrahepatic bile ducts. There was a honeycomb-like tumor stain in the area of cholangiectasis in the left lobe of the liver. The patient was treated by PTCD before cholangioscopy was done by the same route. These findings led us to the diagnosis of mucinous cystadenocarcinoam of the bile duct that had spread from the common bile duct to the intrahepatic bile ducts, as seen from the biopsy specimens. Extended lobectomy of the left lobe, resection of the extrahepatic bile ducts except for the right hepatic duct and common bile duct, and lymph node dissection were carried out. The adenocarcinoma was well differentiated and had not invaded the stroma of the liver or the perineural region.
日本臨床外科学会の論文