title: Intrahepatic cholangiocarcinoma arising 28 years after excision of a type IV-A congenital choledochal cyst: report of a case.
abstract: This report presents a rare case of intrahepatic cholangiocarcinoma (IHCC) arising 28 years after excision of a type IV-A congenital choledochal cyst. The patient underwent excision of a congenital choledochal cyst (Todani's type IV-A) at 12 years of age, with Roux-en-Y hepaticojejunostomy reconstruction. She received a pancreaticoduodenectomy (PD) using the modified Child method for an infection of a residual congenital choledochal cyst in the pancreatic head at the age of 18. She was referred to this department with a liver tumor 22 years later. Left hemihepatectomy with left-side caudate lobectomy was performed and the tumor was pathologically diagnosed to be IHCC. The cause of the current carcinogenesis was presumed to be reflux of pancreatic juice into the residual intrahepatic bile duct during surgery. This case suggests that a careful long-term follow-up is important for patients with congenital choledochal cysts, even if a separation-operation was performed at a young age, and especially after PD.
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan, t.kumamoto@k5.dion.ne.jp.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Kumamoto
authors.forename: Kuniya
authors.initials: K
authors.lastname: Tanaka
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takeda
authors.forename: Kazunori
authors.initials: K
authors.lastname: Nojiri
authors.forename: Ryutaro
authors.initials: R
authors.lastname: Mori
authors.forename: Kouichi
authors.initials: K
authors.lastname: Taniguchi
authors.forename: Ryusei
authors.initials: R
authors.lastname: Matsuyama
authors.forename: Michio
authors.initials: M
authors.lastname: Ueda
authors.forename: Mitsutaka
authors.initials: M
authors.lastname: Sugita
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ichikawa
authors.forename: Youji
authors.initials: Y
authors.lastname: Nagashima
authors.forename: Itaru
authors.initials: I
authors.lastname: Endo
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000379:methods; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D001653:Bile Ducts, Intrahepatic; D017024:Chemotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D015529:Choledochal Cyst / Q000150:complications / Q000601:surgery*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004386:Duodenum / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007582:Jejunostomy / Q000379:methods; D008113:Liver Neoplasms / Q000209:etiology* / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods; D010189:Pancreatic Juice; D013997:Time Factors; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine