Mucin-producing carcinoma of the cystic duct that caused obstructive jaundice

We report a very rare case of what appeared to be mucin-producing carcinoma of the cystic duct, and this is the forth case recorded in the English-language and Japanese literature. The patient was a 67-year-old man with a chief complaint of dark urine and jaundice. Cholangiography via an endoscopic nasobiliary drain showed dilatation of the common hepatic duct to 14mm, with no visualization of the cystic duct or gallbladder, and an approximately 15-mm filling defect was observed at the junction of the common bile duct and the cystic duct. Based on these findings a diagnosis of cancer of the middle portion of the bile duct was made. Cholecystectomy and resection of the bile duct with dissection of regional lymph nodes and choledochoduodenostomy were performed. About a 1-cm mass was palpable in the region of the cystic duct, and the gallbladder contained mucin some of which reached the common bile duct. Histological examination revealed well-differentiated ductal adenocarcinoma infiltrating the serosa, in which mucus production was observed. The patient was discharged on postoperative day 50. At the present time, 38 months postoperatively, there are no signs of recurrence, and he is attending the outpatient clinical in good health.