Shrestha Sujan, Bhandari Ramesh Singh, Shrestha Bibek Man, Shrestha Suraj, Subedi Nirajan, Pradhan Sumita
Department of GI and General Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
Department of GI and General Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
Int J Surg Case Rep. 2021 May;82:105919. doi: 10.1016/j.ijscr.2021.105919. Epub 2021 Apr 27.
Choledochal cysts (CC) are rare cystic dilatation of the biliary trees. Malignancy is one of the important significant findings in CC and its incidence increases with age. Associated squamous cell carcinoma of the choledochal cyst is an uncommon pathological finding.
We present a 21-year-old male diagnosed with type 1 CC and planned for excision of the cystic dilated extrahepatic biliary tract with hepaticojejunal anastomosis in Roux-en-Y but underwent pancreaticoduodenectomy due to intraoperative palpable mass of CC which was adhered to the duodenum and pancreatic head. Histopathology of the excised specimen revealed squamous cell carcinoma (SCC) of the choledochal cyst.
CC represents a rare biliary cystic disease. Though infrequent, malignant transformation in CC includes cholangiocarcinoma, adenocarcinoma, and rarely SCC. The post-operative management for SCC in CC is ill-defined and carries a grave prognosis.
The choledochal cyst should be completely excised wherever possible to avoid the possible malignant transformation in CC including SCC.
胆总管囊肿（CC）是胆管树罕见的囊性扩张。恶性肿瘤是胆总管囊肿的重要显著发现之一，其发病率随年龄增长而增加。胆总管囊肿合并鳞状细胞癌是一种罕见的病理发现。
我们报告一名21岁男性，诊断为1型胆总管囊肿，计划行 Roux-en-Y 肝空肠吻合术切除囊性扩张的肝外胆管，但因术中触及与十二指肠和胰头粘连的胆总管囊肿肿块而接受了胰十二指肠切除术。切除标本的组织病理学显示胆总管囊肿鳞状细胞癌（SCC）。
胆总管囊肿是一种罕见的胆管囊性疾病。虽然不常见，但胆总管囊肿的恶性转化包括胆管癌、腺癌，很少见鳞状细胞癌。胆总管囊肿鳞状细胞癌的术后管理尚不明确，预后严重。
胆总管囊肿应尽可能完全切除，以避免胆总管囊肿包括鳞状细胞癌在内的可能恶性转化。
