A Rare Case of Primary Cystic Duct Adenocarcinoma: A Case Report
Autores
Filipe Amorim-Cruz, Teresa Costa, Mariana Simplicio, Carlos Soares, Luis Graça, Silvestre Carneiro
Resumo Introdução
Primary cystic duct adenocarcinomas are rare and given the limited information on this disease, diagnosis can be challenging. There is still ongoing debate over whether these tumors should be classified as gallbladder carcinoma or extrahepatic cholangiocarcinoma. This paper presents a case report of a patient with a primary cystic duct tumor, detailing their clinical presentation and management.
Resumo Métodos
AAn 81-year-old male presented with a two month history of recurrent abdominal pain. He denied jaundice or changes in stool or urine color. An abdominal ultrasound revealed a distended gallbladder and dilatation of the intra and extrahepatic bile ducts due to a mass obstructing the proximal bile duct. Magnetic resonance imaging showed a papillary lesion in the choledochal lumen with upstream extra and intrahepatic biliary duct dilatation.
Resumo Resultados
The patient underwent a supra-pancreatic common bile duct resection, hepatoduodenal ligament linfadenectomy, and a Roux-en-Y bilioenteric anastomosis. Histopathology revealed a pT2a N0 R0 cystic duct papillary adenocarcinoma with tumor-free margins in the proximal hepatic and distal common bile ducts. The patient is currently under surveillance.
Resumo Discussão
This case report presents a patient with a cystic duct adenocarcinoma, which preoperatively was difficult to distinguish from a hilar cholangiocarcinoma. Surgery is the mainstay of treatment and needs to consider patient and tumor characteristics.