Primary Cystic Duct Carcinoma

Primary cystic duct carcinoma is rare. To date only 27 cases have been reported in the English literature, and 17 cases in the Japanese literature. This paper reports another case of primary cystic duct carcinoma. A 70-year-old male presented with signs and symptoms of acute calcular cholecystitis and dilated extrahepatic bile ducts. An ERCP failed technically. An ultrasound-guided aspiration was performed to drain an obstructed gall bladder and an adjacent pyogenic liver abscess. A cholecystogram showed an obstructed cystic duct. On table a tumour was suspected at the junction of the cystic duct and common hepatic duct (CHD). En masse excision of the gall bladder, cystic duct, tumour, part of the CHD and the supraduodenal part of the common bile duct was performed with a Roux-en-Y hepatico-jejunostomy. Histopathologically the tumour fulfills all of Farrar’s criteria for primary cystic duct carcinoma. Our case is of interest since it is the 2nd case to present with Mirrizzi-like syndrome.