NODULAR CHOLANGIOCELLULAR CARCINOMA ARISING IN S4 WITH PAPILLARY INVOLVEMENT OF THE EXTRAHEPATIC BILIARY TREE-A CASE REPORT-

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  • 肝外胆管内に乳頭状増殖を示した肝Ｓ４原発の結節型胆管細胞癌の１例

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Abstract

This paper reports a case of nodular cholangiocellular carcinoma arising in S4 of the liver with papillary proliferation in the biliary tree.<br> A 67-year-old woman was seen at the hospital because of epigastric pain. Abdominal CT scan showed a tumor with the diameter of 4.5cm in S4 and dilation of the left hepatic duct. ERCP and MRCP showed enlargement of the left hepatic duct and a filling defect with the diameter of 2.5cm in the bile duct at the porta hepatis. Angiography showed a tumor stain corresponding to the filling defect. She was diagnosed as having primary hepatic cancer with bile duct involvement and underwent surgery. After resection of the left lobe of the liver and the cystic duct, reconstruction was done with right hepatocholan-giojejunostomy. Histopathological examination showed that the tumor was moderately differentiated cholangiocellular carcinoma with papillary involvement of the bile duct. The postoperative course was uneventful, and she was discharged on the 39th day after admission. She has been in good health without any signs of recurrence for 73 months postoperatively. In Japan, only 6 cases have been reported of nodular cholangiocellular carcinoma with papillary involvement of the bile duct at the porta hepatis.

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