Journal of the Korean Association of Pediatric Surgeons  2005;11(2):186-191

Malignant Degeneration and Hepatic Metastasis Related to Choledochal Cyst with Internal Drainage Procedure: a Case Report.

Moonjong JI 1 ; Hyukjin YOON ; Shinyong KANG ; Jinyoung PARK

Affiliations

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Keywords

Choledochal cyst; Malignant degeneration

Country

Republic of Korea

Language

Korean

Abstract

A 10-year-old-girl who underwent Roux-en-Y cystojejunostomy under the diagnosis of choledochal cyst at another hospital at the age of 3 months was referred to our hospital due to abdominal pain. Abdominal ultrasonography (USG) and computed tomography (CT) showed the type I choledochal cyst and multiple gall bladder stones. Severe inflammation and adhesion made difficulty of radical resection and only partial resection of choledochal cyst with Roux-en-Y hepaticojejunostomy could be performed. She complained of intermittent abdominal pain, fever, nausea and vomiting 2 1/2 years after the second operation. Follow-up abdominal CT scan showed the polypoid nodular lesion in the remnant choledochal cyst and suspicious metastatic lesion in the segment 7 of the liver. The duodenum was obstructed by the mass arising from the remnant choledochal cyst. The USG-guided liver biopsy revealed the moderately differentiated adenocarcinoma. A secondary palliative gastrojejunostomy was performed to relieve the obstruction of duodenum. She died of hepatic insufficiency 4 months later of third operation.