A CASE OF PRIMARY BILIARY CYSTADENOCARCINOMA-A REVIEW OF REPORTED CASES OF PRIMARY BILIARY CYSTADENOCARCINOMA IN JAPAN-

Abstract

This is a report of a relatively rare case of primary biliary cystadenocarcinoma. A 71-year-old male was seen at the hospital because of epigastric pain. Physical examination on admission revealed neither jaundice nor anemia. Palpation of the abdomen revealed tenderness and slight rebound tenderness in the epigastric area. Laboratory findings were unremarkable except for leukocytosis. All tumor markers were in the normal range. Abdominal ultrasonogram and CT scan revealed a cystic lesion with a papillary process in the descending branch of the left intrahepatic bile duct. Cytology resulted in class II cells. PTC and ERCP demonstrated partial cystic dilatation in the same region. Primary cystadenocarcinoma of the intrahepatic bile duct was suspected, and extended left lateral segmentectomy with dissection of the involved lymph nodes was performed. Examination of the resected specimen revealed a 1.8cm multicystic tumor with a papillary process in the descending branch of the left intrahepatic bile duct. Histologically the bulk of the cystic wall was made up of mucinous cystadenoma and partly coexistence of adenocarcinoma and serous cystadenoma was confirmed. The patient is doing well and there has been no recurrence as of 2 years and 5 months after the surgery. A review of the literature revealed 79 reported cases of primary biliary cystadenocarcinoma in Japan. The findings of these reported cases was also evaluated.