title: Mirizzi syndrome secondary to an adenoma of the cystic duct.
abstract: Bile duct adenomas are uncommon lesions that can cause obstructive jaundice. We report the unusual case of a 54-year-old man who developed Mirizzi syndrome secondary to a bile duct papillary adenoma located in the cystic duct remnant. A case report is presented, together with a review of extrahepatic bile duct adenomas published in the English-language literature, with special attention directed toward the clinical manifestations, locations, and prognosis of these tumors. Bile duct adenomas are very rare tumors. Although cholangiography can detect many of these lesions, few cases were correctly diagnosed preoperatively. Most lesions were located in the distal common bile duct or at the ampulla of Vater. Pathologic examination often revealed foci of carcinoma in situ, dysplasia, or atypia. Local resection was performed in most cases. There were no previous case reports of extrinsic common bile duct obstruction caused by tumors within the cystic duct. We describe here a very rare, acalculous variant of Mirizzi syndrome secondary to a solitary papillary adenoma of the cystic duct. In general, bile duct adenomas are uncommon lesions that are difficult to diagnoses preoperatively. These tumors usually present with jaundice secondary to intraluminal biliary obstruction. These lesions are premalignant and should be managed by complete surgical resection.
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, WHT 515, Boston, MA 02114, USA.
authors.forename: Shaun M
authors.initials: SM
authors.lastname: Kunisaki
authors.forename: Martin
authors.initials: M
authors.lastname: Hertl
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Bodner
authors.forename: A Benedict
authors.initials: AB
authors.lastname: Cosimi
mesh_terms: D000236:Adenoma / Q000150:complications*; D001650:Bile Duct Neoplasms / Q000150:complications*; D002779:Cholestasis / Q000209:etiology*; D003549:Cystic Duct; D006801:Humans; D008297:Male; D008875:Middle Aged; D013577:Syndrome