An incidental finding of carcinoid tumor of the cystic duct

Abstract

Cystic duct carcinoids are extremely rare tumors. We present a 58-year-old female with carcinoid tumor found within the cystic duct margin following laparoscopic cholecystectomy. She subsequently underwent surgical resection with a Roux-en-Y hepaticojejunostomy. No standard guidelines currently exist regarding surgical excision of these rare tumors. Therefore, we conducted a thorough review of the literature to recommend complete oncologic surgical resection with re-establishment of biliary continuity as the mainstay of definitive treatment; adjuvant therapy currently remains investigational. Long-term prognosis is good with this approach.

Carcinoid Tumor of the Cystic Duct: Case Report, Literature Review and Comparison of Surgical Approaches

“…A carcinoid of the cystic duct arises from enterochromaffin cells, which are neuroendocrine cells of the GI tract [ 5 ]. These tumors have been found to be more prevalent in women than in men (8 out of 10 cases) [ 3 , 6 ]. Patients’ ages range from 28 to 69 years [ 2 , 3 ], and the most common preoperative complaint is right upper quadrant abdominal pain [ 3 , 6 ].…”

“…These tumors have been found to be more prevalent in women than in men (8 out of 10 cases) [ 3 , 6 ]. Patients’ ages range from 28 to 69 years [ 2 , 3 ], and the most common preoperative complaint is right upper quadrant abdominal pain [ 3 , 6 ]. All cystic duct carcinoids reported were found incidentally upon laparotomy or laparoscopy with pathologic analysis.…”

“…Laparoscopic or open surgery is performed to obtain clear margins. In the only other reported laparoscopic removal of the cystic duct carcinoid [ 3 ], a Roux-en-Y hepaticojejunostomy was performed in conjunction with the excision of a large mesenteric lymph node. In this case, the patient had locoregional disease.…”

“…An extremely rare site of GI carcinoid tumor is the extrahepatic biliary tree, harboring 0.1–0.2% of all GI tumors [ 2 ]. In the extrahepatic biliary tree, cystic duct carcinoids represent 11% [ 3 ] of all reported cases.…”