Malignant Tumors in Choledochal Cysts

Tsuchiya, Ryôichi; Harada, Nobuhiro; Itô, Takahiro; Furukawa, Masaya; Yoshihiro, I

doi:10.1097/00000658-197707000-00004

Cited by 116 publications

(45 citation statements)

References 16 publications

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“…The incidence of malignancy ranges from 10% to 30%. [10][11][12][13][14][15] Complete cystic excision with hepaticoenterostomy is the standard surgical strategy because it lowers the risk of malignancy arising from the residual cyst. However, there is a lack of consensus about the optimal timing of surgery.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Feature and Surgical Outcome of Choledochal Cyst in Different Age Groups: The Implication of Surgical Timing

Tsai

Lin

Hsu

et al. 2008

Journal of Gastrointestinal Surgery

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Section: Discussionmentioning

confidence: 99%

Clinicopathological Feature and Surgical Outcome of Choledochal Cyst in Different Age Groups: The Implication of Surgical Timing

Tsai

Lin

Hsu

et al. 2008

Journal of Gastrointestinal Surgery

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“…Gallbladder carcinoma is associated with AJPBD in approximately 10% of patients. In this regard, several investigations revealed that among AJPBD patients without a dilatation of common bile duct, the incidence of gallbladder carcinoma is higher than in those with choledochal cyst, a cystic dilatation of common bile duct [35,36,37].…”

Section: Anomalous Junction Of the Pancreaticobiliary Ductmentioning

confidence: 99%

Carcinogenesis of malignant lesions of the gall bladder

Tazuma

Kajiyama

2001

Langenbeck's Arch Surg

111

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Gallbladder carcinoma is an uncommon but highly malignant tumor with a poor 5-year survival rate. The presence of gallstones is a well-established risk factor for gallbladder carcinoma, and the risk seems to correlate with stone size. Metaplastic changes of the gallbladder epithelium present in chronic cholecystitis may be a premalignant lesion. Solitary polyps with a size of greater than 1 cm are recognized as a predisposing factor for gallbladder carcinoma when their characteristics are echopenic, sessile, and high cell density. Endoscopic ultrasound is the most useful technique to detect the early changes of malignancy in polyps. Anomalous junction of pancreaticobiliary ducts (AJPBD) without a choledochal cyst and porcelain gallbladder is an additional risk factor for gallbladder malignancy. At the molecular level, it has been proposed that chronic inflammation of the gallbladder may lead to the loss of p53 gene heterozygosity and excessive expression of p53 protein. Furthermore, a proposed mechanism underlying the high risk of gallbladder carcinoma in patients with AJPBD is that chronic reflux of pancreatic juice causes intestinal metaplasia, hyperplasia, and dysplasia with the mutation of p53 and K-ras. In contrast, the causal relationship between porcelain gallbladder and malignancy is yet to be established. In this article, recognition of risk factors for gallbladder carcinoma was summarized with special attention to gallstones and chronic inflammation.

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“…Multiple factors such as mechanical irritation by calculi, bile stasis, and bacterial infection seem to be factors in the etiology of biliary carcinoma. A further specific and well-documented risk factor for biliary cancer is congenital choledochal cyst, which is almost always associated with the anomalous arrangement of the pancreatobiliary duct system [7, 8]. This anomaly allows reflux of pancreatic juice into the biliary tree.…”

Section: Discussionmentioning

confidence: 99%

Bile Duct Cancer Developing 21 Years after Choledochoduodenostomy

et al. 2003

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Background: Cholangiocarcinoma in patients with choledochoenterostomy has been a rare condition with few cases reported in the literature written in English, and there have been few pathological descriptions of this disease. However, it has recently been documented as a late complication of choledochoenteric anastomosis, and has become a serious issue today since choledochoenterostomy and sphincteroplasty for benign biliary lesions were frequently resorted to in the 1970s and 1980s. The authors here present a case of a 67-year-old woman who developed a cholangiocarcinoma 21 years after choledochoduodenostomy. Methods: The patient underwent a curative resection of the tumor with a hepatopancreatoduodenectomy after a detailed preoperative assessment, including cholangiography and cholangioscopy. Results: Although this tumor has been reported to have a poor prognosis, a precise preoperative evaluation and aggressive surgery may contribute to better survival. Pathologically, the tumor originated in the bile duct mucosa of the choledochoduodenostomy, and was accompanied by intestinal and pyloric gland-like metaplasia. Conclusion: These epithelial changes presumably induced by chronic inflammation due to the reflux of intestinal contents and bile stasis may be responsible for the carcinogenesis.

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Malignant Tumors in Choledochal Cysts

Cited by 116 publications

References 16 publications

Clinicopathological Feature and Surgical Outcome of Choledochal Cyst in Different Age Groups: The Implication of Surgical Timing

Clinicopathological Feature and Surgical Outcome of Choledochal Cyst in Different Age Groups: The Implication of Surgical Timing

Carcinogenesis of malignant lesions of the gall bladder

Bile Duct Cancer Developing 21 Years after Choledochoduodenostomy

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