Skip to main content

Advertisement

Log in

Double cancer of the cystic duct and gallbladder associated with low junction of the cystic duct

  • Case Reports of Interest
  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

We report a case of double cancer of the cystic duct and gallbladder associated with low junction of the cystic duct. A 73-year-old woman was admitted to the hospital complaining of upper abdominal pain. Endoscopic retrograde cholangiography showed a stenotic lesion in the lower common bile duct and no visualization of the cystic duct or gallbladder. Enhanced computed tomography revealed a heterogeneously enhanced tumorous lesion around the lower bile duct in the pancreatic head. A diagnosis of cancer arising from the cystic duct that entered the lower part of the common hepatic duct was made by intraductal ultrasonography, which showed an intraluminal protruding lesion in the cystic duct. Isolated gallbladder cancer was also diagnosed, by abdominal computed tomography. She underwent pancreaticoduodenectomy with dissection of regional lymph nodes. Histological examination revealed moderately differentiated adenocarcinoma of the cystic duct and well-differentiated adenocarcinoma of the gallbladder. Double cancer of the cystic duct and gallbladder is extremely rare, and this case also suggests a relationship between a low junction of the cystic duct and neoplasm in the biliary tract.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Farrar DAT. Carcinoma of the cystic duct. Br J Surg 1951;39:183–185.

    Article  PubMed  CAS  Google Scholar 

  2. Ozden I, Kamiya J, Nagino M, Vesaka K, Oda K, Sano T, et al. Cystic duct carcinoma: a proposal for a new “working definition”. Langenbecks Arch Surg 2003;387:337–342.

    PubMed  Google Scholar 

  3. Glenn F, Hill MR Jr. Extrahepatic biliary tract cancer. Cancer 1955;8:218–225.

    Article  Google Scholar 

  4. Chan KM, Yeh TS, Tseng JH, Liu NJ, Jan YY, Chen MF. Clinicopathological analysis of cystic duct carcinoma. Hepatogastroenterology 2005;52:691–694.

    PubMed  Google Scholar 

  5. Ohtani T, Shirai Y, Tsukada K, Hatakeyama K, Muto T. The association between extrahepatic biliary carcinoma and the junction of the cystic duct and the biliary tree. Eur J Surg 1994;160:37–40.

    PubMed  CAS  Google Scholar 

  6. Sato M, Watanabe Y, Kikkawa H, Kohtani T, Suzuki H, Nezu K, et al. Carcinoma of the cystic duct associated with pancreaticobiliary maljunction. J Gastroenterol 2001;36:276–280.

    Article  PubMed  CAS  Google Scholar 

  7. Shibata Y, Toyoda S. Carcinoma of the cystic duct protruding into the common bile duct: report of a case. Surg Today 1995;25:1050–1053.

    Article  PubMed  CAS  Google Scholar 

  8. Ishiguro Y, Goto H, Hirooka Y, et al. A case of primary carcinoma of the cystic duct detected by intraductal ultrasonography (IDUS) (in Japanese). Gastroenterol Endosc 1997;39:1608–1613.

    Google Scholar 

  9. Osanai M, Maguchi H, Urata T, Matsuzaki S, Nakahara K, Katanuma A, et al. Current status of diagnosis for cystic duct carcinoma (in Japanese). Journal of Gastroenterological Imaging 2006;8:193–199.

    Google Scholar 

  10. Nemoto A, Goshima H, Yoshimine S, Higashiguchi T, Takagi K, Fujii K, et al. Mucin-producing carcinoma of the cystic duct that caused obstructive jaundice. Hepatogastroenterology 2003;50:1250–1254.

    PubMed  Google Scholar 

  11. Hasumi A, Matsui H, Sugioka A, Ueyama I, Komori Y, Fujita J, et al. Precancerous conditions of biliary tract cancer in patients with pancreaticobiliary maljunction: reappraisal of nationwide survey in Japan. J Hepatobiliary Pancreat Surg 2000;7:551–555.

    Article  PubMed  CAS  Google Scholar 

  12. Seki M, Yanagisawa A, Ninomiya E, Ohta H, Saiura A, Yamamoto J, et al. Clinicopathology of pancreaticobiliary maljunction: relationship between alterations in background biliary epithelium and neoplastic development. J Hepatobiliary Pancreat Surg 2005;12:254–262.

    Article  PubMed  Google Scholar 

  13. Tokiwa K, Ono S, Iwai N. Mucosal cell proliferation activity of the gallbladder in children with anomalous arrangement of the pancreaticobiliary duct. J Hepatobiliary Pancreat Surg 1999;6:213–217.

    Article  PubMed  CAS  Google Scholar 

  14. Nakao A, Sakagami K, Uda M, Mitsuoka S. Double cancers of the gallbladder and bile duct associated with anomalous choledochopancreatic duct junction. J Gastroenterol 1997;32:110–113.

    Article  PubMed  CAS  Google Scholar 

  15. Takayashiki T, Miyazaki M, Kato A, Ito H, Nakagawa K, Ambiru S, et al. Double cancer of gallbladder and bile duct associated with anomalous junction of the pancreaticobiliary ductal system Hepatogastroenterology 2002;49:109–112.

    PubMed  Google Scholar 

  16. Fujii T, Kaneko T, Sugimoto H, Okochi O, Inoue S, Takeda S, et al. Metachronous double cancer of the gallbladder and common bile duct. J Hepatobiliary Pancreat Surg 2004;11:280–285.

    PubMed  Google Scholar 

  17. Uetsuji S, Okuda Y, Kwon AH, Komada H, Imamura A, Takai S, et al. Gallbladder cancer with a low junction of the cystic duct or an anomalous pancreaticobiliary junction. Eur J Gastroenterol Hepatol 1996;8:1213–1217.

    Article  PubMed  CAS  Google Scholar 

  18. Uetsuji S, Okuda H, Komada H, Yamamura M, Kamiyama Y. Clinical evaluation of a low junction of the cystic duct. Scand J Gastroenterol 1993;28:85–88.

    Article  PubMed  CAS  Google Scholar 

  19. Drinka P, Sheehy G. Clonorchis sinensis infection associated with adenocarcinoma of the gallbladder and cystic duct. Wis Med J 1985;84:16–18.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Itoh, T., Fuji, N., Taniguchi, H. et al. Double cancer of the cystic duct and gallbladder associated with low junction of the cystic duct. J Hepatobiliary Pancreat Surg 15, 338–343 (2008). https://doi.org/10.1007/s00534-007-1245-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00534-007-1245-2

Key words

Navigation