title: Intrahepatic cholangiocarcinoma arising 34 years after excision of a type IV-A congenital choledochal cyst: report of a case.
abstract: We report a rare case of intrahepatic cholangiocarcinoma (IHCC) arising many years after excision of a type IV-A congenital choledochal cyst. A 44-year-old man was transferred to our hospital with acute cholangitis more than 34 years after several operations for congenital biliary dilatation. Imaging showed a huge tumor in the left medial section of the liver, extending to the porta hepatis. Although he had no jaundice, the intrahepatic bile ducts showed cylinder-like dilatation with narrowing of the hilar bile duct. At surgery, the tumor was found to arise from the dilated intrahepatic bile duct just above the narrow portion. He underwent a left hepatic trisectionectomy with a vascular procedure. Microscopically, the tumor was confirmed to be moderate-to-well-differentiated tubular adenocarcinoma. Thus, when the narrow segment is left untouched, careful long-term follow-up is important to detect new lesions at an early stage.
authors.affiliation: Division of Digestive and General Surgery, Department of Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Shimamura
authors.forename: Isao
authors.initials: I
authors.lastname: Kurosaki
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sato
authors.forename: Kabuto
authors.initials: K
authors.lastname: Takano
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Yokoyama
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Sato
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Hatakeyama
authors.forename: Keiko
authors.initials: K
authors.lastname: Nakadaira
authors.forename: Minoru
authors.initials: M
authors.lastname: Yagi
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D000328:Adult; D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000002:abnormalities / Q000601:surgery; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D015529:Choledochal Cyst / Q000150:complications* / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed