title: Intrahepatic cholangiocarcinoma arising 10 years after the excision of congenital extrahepatic biliary dilation.
abstract: A 52-year-old woman was found to have a liver tumor during treatment for a liver abscess. The tumor was diagnosed as intrahepatic cholangiocarcinoma by closer examinations, including a percutaneous needle biopsy. Ten years previously, she had undergone excision of a choledochal cyst, with reconstruction by Roux-en-Y hepaticojejunostomy, as treatment for Todani's type Ia congenital biliary dilation, which had been confined only to the extrahepatic bile duct. The significant association between congenital biliary dilation and hepatobiliary malignancies is well known. Some patients have been reported to develop biliary cancer long after the excision of the entire extrahepatic bile duct and hepaticoenterostomy. However, in these patients, the development mostly took place in the remnant choledochal cyst, the anastomotic site, or in the dilated intrahepatic bile duct of Todani's type IV-A congenital biliary dilation. The development of intrahepatic cholangiocarcinoma after operation has not been reported previously in a patient with Todani's type I congenital biliary dilation. This case suggests that the entire biliary tree may have a high risk of field cancerization, even in extrahepatic congenital biliary dilation.
authors.affiliation: First Department of Internal Medicine, Gifu University School of Medicine, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Goto
authors.forename: I
authors.initials: I
authors.lastname: Yasuda
authors.forename: T
authors.initials: T
authors.lastname: Uematsu
authors.forename: N
authors.initials: N
authors.lastname: Kanemura
authors.forename: S
authors.initials: S
authors.lastname: Takao
authors.forename: K
authors.initials: K
authors.lastname: Ando
authors.forename: T
authors.initials: T
authors.lastname: Kato
authors.forename: S
authors.initials: S
authors.lastname: Osada
authors.forename: H
authors.initials: H
authors.lastname: Takao
authors.forename: S
authors.initials: S
authors.lastname: Saji
authors.forename: K
authors.initials: K
authors.lastname: Shimokawa
authors.forename: H
authors.initials: H
authors.lastname: Moriwaki
mesh_terms: D001649:Bile Duct Diseases / Q000150:complications* / Q000151:congenital* / Q000601:surgery; D001650:Bile Duct Neoplasms / Q000209:etiology* / Q000473:pathology; D017734:Bile Ducts, Extrahepatic / Q000002:abnormalities* / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D018281:Cholangiocarcinoma / Q000209:etiology* / Q000473:pathology; D004108:Dilatation, Pathologic / Q000150:complications / Q000151:congenital / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors