Document Detail

Carcinoma arising in congenital choledochal cysts.
MedLine Citation:
PMID:  18613359     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/AIMS: Congenital choledochal cyst is almost always associated with pancreaticobiliary maljunction and is sometimes associated with biliary carcinoma. This study aimed to investigate the clinicopathological features and surgical treatment of choledochal cyst associated with carcinoma arising in the cyst wall. METHODOLOGY: Relationship of the clinicopathological findings and surgical treatment of 8 patients with histologically proven carcinoma that had developed in the choledochal cyst wall were examined to determine mode of tumor spread, multicentric tumor origins, and coincidence with other neoplastic lesions. RESULTS: Papillary adenocarcinoma (n = 5) had different clinicopathological features than tubular adenocarcinoma (n = 3). Radiologically, papillary adenocarcinoma presented as an eccentrically located polypoid mass in the cyst, while with tubular adenocarcinoma, there was evidence of bile duct stenosis with irregular thickening of the bile duct wall. Papillary adenocarcinoma was associated with extensive superficial spread (n = 1), synchronous (n = 2), or metachronous (n = 2) multicentric tumors. Pancreatoduodenectomy with (n = 1) or without (n = 1) hepatic lobectomy, and repeated resection by hepatic lobectomy (n = 2) were performed for these circumstances of tumors. Extensive or repeated resections allowed 3 patients to live longer than 2 years. Tubular adenocarcinoma was associated with scirrhously infiltrative spread and a poor prognosis. CONCLUSIONS: Papillary adenocarcinoma frequently occurs in the choledochal cyst wall. Since aggressive resection offers survival benefits in papillary adenocarcinoma arising in the choledochal cyst wall, the presence of superficial spread and multicentric tumors should be identified and taken into account when planning surgery. Patients require close monitoring so that recurrent carcinoma of the remnant bile duct can be identified early.
Terumi Kamisawa; Atsutake Okamoto; Kouji Tsuruta; Yuyang Tu; Naoto Egawa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  55     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2008 Mar-Apr
Date Detail:
Created Date:  2008-07-10     Completed Date:  2008-12-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  329-32     Citation Subset:  IM    
Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan.
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MeSH Terms
Bile Duct Neoplasms / complications*
Carcinoma / complications*,  diagnosis
Choledochal Cyst / complications*,  diagnosis
Middle Aged

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