PMC3980419_01
Magnetic resonance cholangiopancreatography showing dilatation of common bile duct and right biliary system. GB: gall bladder, CBD: common bile duct, CHD: common hepatic duct, RPSD: right posterior sectorial duct.
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As complete excision is the best management strategy of choledochal cyst, the patient was evaluated for right hepatectomy with extrahepatic biliary resection (Fig. 1).
Computed tomography showing dilated biliary system on the right side with compressed portal vein carina and right portal branch by the cystic lesion in the right lobe.
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Computerized tomographic portography revealed compressed portal vein carina and right portal branch by the cystic lesion in the right lobe (Fig. 2).
Operative photo showing cystic dilatation in the extrahepatic bile duct.
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On surgical exploration, there was enlarged liver especially right lobe, dilated CBD (30 mm) (Fig. 3).
Intraoperative cholangiogram showing cystic dilatation in the extrahepatic bile duct and the intrahepatic biliary tree in the right hemiliver.
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Intraoperative cholangiogram was done and revealed dilated biliary system, fusiform dilatation along CHD and right posterior hepatic duct (Fig. 4).
The surgical specimen showing the resected right hemiliver measuring 15 cm x 12 cm x 5 cm and extrahepatic biliary tree.
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S-100, synaptophysin and chromogranin are negative (Figs. 5-8).
The tumor tissue is seen infiltrating large portal area (H&Ex 100).
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S-100, synaptophysin and chromogranin are negative (Figs. 5-8).
The tumor tissue is focally positive to desmin (Peroxidasex200).
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S-100, synaptophysin and chromogranin are negative (Figs. 5-8).
The tumor cell nuclei are focally positive to myogenin (Peroxidasex200).
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S-100, synaptophysin and chromogranin are negative (Figs. 5-8).