A CASE OF HILAR CARCINOMA OF THE BILE DUCT WITH A RECURRENCE IN THE SPLENIC FLEXURE

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This paper describes a surgical resection of a solitary cystic recurrent tumor in the splenic flexure in a patient with hilar carcinoma of the bile duct, who also experienced a local recurrence one year earlier. A 56-year-old woman was admitted to the hospital because of appetite loss and left upper abdominal pain. These were previous histories of undergoing left hepatectomy and caudate lobectomy as a complete curative operation for a left hilar carcinoma of the bile duct in December 1989; and enucleation of a tumor recurring at the residual liver cut surface with a high level of CEA in September, 1991. This time CT showed an abdominal cystic tumor about 5cm indiameter in the splenic flexure, barium enema revealed a stenosis of splenic flexure due to extraserosal compression, and carcinoma cells (class V) were evidenced by the aspiration cytology. The third operation was done with a preoperative diagnosis of the recurrence of the hilar bile duct carcinoma. The tumor was placed in the omentum with invasion into to the colon, of which pathological findings were considered as the recurrence.
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