Normal Measurement of Diameters of the Common Bile Ducts in Different Aged Groups.

Background: Computed tomography (CT) is widely used in diagnosis of biliary disorders in adults yet there is no data on the normal common bile duct (CBD) size of the average Thai adult. This study attempts to establish a reference normal measurement for CBD diameter for the Thai population. Material and Method: In this retrospective study, CBD measurements were performed on axial oblique images, perpendicular to the long axis of the distal CBD. The mean diameter of the normal CBD was measured in 277 patients. The patients were divided into 7 groups according to their age. Analysis of variance (ANOVA) was used to compare data obtained from the seven age groups. Results: Mean diameter of CBD ranged from 2.3 to 9.5 mm. The mean of the mean diameter of 277 subjects was 4.65±1.39 mm. The diameter of the CBD significantly increased with age (p<0.05), and are not significantly related to gender. Conclusion: Diameter of CBD shows a considerable increase with age. The largest diameter of the CBD is up to 6.4 mm in patients who less than 60 years. An upper limit of 8 mm appears reasonable after the age of 60.

Co-Existing Ovarian Mucinous Cystadenocarcinoma with Mature Cystic Teratoma: A Rare Case Report.

Background: Mature cystic teratoma is the most common benign germ cell ovarian tumor. Malignant transformation is uncommon. The pathology is mostly composed of squamous cell carcinoma. Mucinous cystadenocarcinoma should be differentiated between malignant transformation and the coincidental occurrence. Case Report: A case of an early stage mucinous ovarian cancer co-existing with mature cystic teratoma at the same ovarian side was reported. A 57-year-old woman presented with incidental palpable pelvic mass for two weeks. Right ovary consisted of multiloculated cyst and mature cystic teratoma. The patient underwent an exploratory laparotomy for a large ovarian cyst evaluation. Mucinous ovarian cancer was diagnosed as FIGO stage IC3 after operation. Histopathology report showed mucinous cystadenocarcinoma and mature cystic teratoma of the right ovary. There was no additional abdominal abnormality. Immunohistochemistry staining supported the diagnosis of metastatic adenocarcinoma of colon or intestinal type of mucinous ovarian cancer. Further investigation for locating other primary cancer site was then performed. The result was negative. The intestinal-type mucinous ovarian cancer co-existing with mature cystic teratoma of the right ovary was the final histopathological reading. The patient was then started on carboplatin/paclitaxel combination chemotherapy for 6 cycles after surgery. The patient showed complete remission at the end of the chemotherapy treatment. Conclusion: This was a rare case of mucinous ovarian cancer co-existing with mature cystic teratoma. Clinical acumen, immunochemistry staining and metastatic survey investigation played important roles for the final diagnosis.