Korean J Hepatobiliary Pancreat Surg.  2015 May;19(2):75-77. 10.14701/kjhbps.2015.19.2.75.

Bilateral ovarian metastasis from distal common bile duct carcinoma developing after choledochal cyst excision

Affiliations
  • 1Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea. selee508@cau.ac.kr
  • 2Department of Pathology, Chung-Ang University College of Medicine, Seoul, Korea.
  • 3Devision of Gastroenterology, Chung-Ang University College of Medicine, Seoul, Korea.

Abstract

Ovarian metastases represent about 3-5% of all ovarian malignancies. Most of these tumors originate in the digestive tract and cholangiocarcinoma rarely involves the ovary. A 60-year-old woman was admitted for the investigation of abdominal distension that had lasted 1 week. One and a half years prior, the patient had undergone choledochal cyst excision, Roux-en Y hepaticojejunostomy and cholecystectomy. Computed tomography scans of the abdomen revealed a papillary mass in the remnant distal common bile duct and enlargement of both ovaries with a huge amount of ascites. An explorative laparotomy disclosed no peritoneal seeding with resectable cholangiocarcinoma and bilateral ovarian mass. Pylorus-preserving pancreatoduodenectomy and bilateral salphingo-oophorectomy with hysterectomy were performed. Histologically, it was a well-differentiated adenocarcinoma and all surgical margins were free of tumor. Both ovarian masses were consistent with metastatic adenocarcinoma from the common bile duct. The patient received six cycles of postoperative adjuvant systemic chemotherapy, dying after 10 months due to pulmonary embolism.

Keyword

Common bile duct; Choledochal cyst; Metastasis; Ovarian neoplasm

MeSH Terms

Abdomen
Adenocarcinoma
Ascites
Cholangiocarcinoma
Cholecystectomy
Choledochal Cyst*
Common Bile Duct*
Drug Therapy
Female
Gastrointestinal Tract
Humans
Hysterectomy
Laparotomy
Middle Aged
Neoplasm Metastasis*
Ovarian Neoplasms
Ovary
Pancreaticoduodenectomy
Pulmonary Embolism

Figure

  • Fig. 1 Computed tomography scan showing papillary mass in the remnant distal common bile duct (arrow).

  • Fig. 2 Computed tomography scan showing bilateral enlargement of ovaries (arrows) with huge amount of ascites.


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