A Case of Asymptomatic, Anicteric Early-stage Intrahepatic Ductal Cholangiocarcinoma / 대한소화기내시경학회지

ABSTRACT

Asymptomatic intrahepatic early-stage bile duct carcinoma without jaundice is difficult to diagnose because it does not have any characteristic clinical signs and symptoms. The clinical implication of early-stage intrahepatic ductal cholangiocarcinoma is great, because it allows curative resection and excellent long-term survival. Recently we experienced early-stage intrahepatic cholangiocarcinoma which was incidentally detected by a clue of elevated serum alkaline phosphatase and gamma-GT without jaundice and any symptoms. Abdominal US showed focal intrahepatic bile duct dilatation. ERCP could not demonstrate the lesion, while MRCP revealed the obstructed duct (S6) with proximal dilatation. For evaluation of a focal intrahepatic stricture, PTCS examination and biopsy were done. With the help of MRCP and PTCS, the lesion was diagnosed as papillary adenocarcinoma preoperatively. The patient was underwent right liver lobectomy and confirmed early-stage intrahepatic ductal adenocarcinoma and she is well-being without cancer recurrence for a follow-up period of 1 year.