Superficially spreading cholangiocarcinoma

Cholangiocarcinoma of a raised, elevated type, not an infiltrative type, may be accompanied with superficial spread in the continguous mucosa. We report a case of an extrahepatic cholangiocarcinoma that showed a specific cholangiographic finding of extensive superficial spread. The patient was a 62-yr-old man. Cholangiography revealed an elevated lesion in the middle of the bile duct, which was surrounded by irregularity of the bile duct wall extensively. We accurately diagnosed the tumor extent by percutaneous transhepatic cholangioscopy and achieved radical resection without hepatic resection. The margins were tumor-negative by microscopy. In conclusions, it is important to accurately diagnose the extent of superficial spread preoperatively by cholangioscopy and biopsy, and decide the resecting lines to make margins tumor-negative.