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Kim, Kim, Kang, Kim, Lee, Lee, Kim, and Park: A Case of Intrahepatic Cholangiocarcinoma Associated with Type IV Choledochal Cyst
Case Report
The Korean Journal of Gastroenterology

The Korean Journal of Gastroenterology 2012; 60(2): 123-127.

Published online: 22 August 2012

DOI: https://doi.org/10.4166/kjg.2012.60.2.123

A Case of Intrahepatic Cholangiocarcinoma Associated with Type IV Choledochal Cyst

Suk Hun Kim, Hyung Wook Kim, Dae Hwan Kang, Min Dae Kim, Jin Ho Lee, Jae Hyung Lee, Bong Gap Kim, Jong Hwan Park

Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Korea.

Correspondence to: Hyung Wook Kim, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 626-787, Korea. Tel: +82-55-360-1534, Fax: +82-55-360-1536, mdkhwook@gmail.com

Received 9 June 2011       Revised 19 August 2011       Accepted 19 August 2011

Copyright © 2012 The Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Anomalous union of the pancreaticobiliary duct (AUPBD) is a congenital anomaly that is defined as a junction of the bile duct and pancreatic duct outside the duodenal wall. This anomaly results in a loss of normal sphincteric mechanisms at the pancreaticobiliary junction. As a result, regurgitation of pancreatic juice into the biliary system develops and causes choledochal cysts, choledocholithiasis, cholangitis, pancreatitis and malignancy of the biliary tract. Gallbladder cancer or common bile duct cancer associated with AUPBD and choledochal cysts have been frequently reported. But, intrahepatic cholangiocarcinoma associated with this condition has been only rarely reported. Here, we report a case of intrahepatic cholangiocarcinoma associated with AUPBD and choledochal cyst.

Keywords: Anomalous union of pancreaticobiliary duct, Choledochal cyst, Intrahepatic cholangiocarcinoma

Figures and Tables

Fig. 1
Abdominal CT findings. Abdominal CT scan showed papillary projected mass (arrow) with ductal dilation in the left intrahepatic duct (A) and ductal dilation of the right intrahepatic duct and the common bile duct (B), right intrahepatic solid mass (arrow) (C). Also abdominal CT showed both kidneys with large, multiple cysts.
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Fig. 2
MRCP findings. (A) MRCP showed dilation of the common bile duct and anomalous union of pancreaticobiliary duct (arrow). (B) The additional small, papillary mass (white arrow) was also seen in the right intrahepatic duct (IHD) with large projected solid mass (black arrow) in left IHD.
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Fig. 3
ERCP findings. (A) It showed fusiform dilation of the common bile duct and papillary mass in the left intrahepatic duct (IHD) (arrow). (B) Endoscopic naso biliary drainage tubography showed small, papillary mass in the right IHD (arrow).
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Fig. 4
PET-CT findings. It showed hypermetabolic mass (SUVmax 14.9) in the left intrahepatic duct, suggesting malignant mass.
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Fig. 5
Moderately differentiated adenocarcinoma was seen (H&E). (A) ×100, (B) ×400.
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Notes

Financial support: None.

Conflict of interest: None.

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