Adenocarcinoma in Choledochal Cyst
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Case Report
A 19-year-old male presented with pain and lump in the abdomen of 6-month duration. Patient was icteric, and abdominal examination revealed a mass of 10?×?10 cm in the right hypochondrium. Investigations revealed raised bilirubin and enzyme levels including alkaline phosphatase. Coagulation profile and CEA was normal.

USG of the abdomen revealed a cystic lesion with intraluminal echogenicity in the subhepatic region and distended gall bladder with dilated cystic and hepatic ducts diagnosed as choledochal cyst. Contrast enhanced computerized tomography revealed a choledochal cyst (Todani type IVa) complicated by polypoidal intraluminal SOL. MRCP also confirmed the findings of CECT. Preoperative, there was a type IVa choledochal cyst extending below the second part of the duodenum. Excision of the cyst with Roux-en-Y hepaticojejunostomy was done. Two polypoidal masses were attached to the posterior wall of the cyst. Histopathology revealed early infiltrative moderately differentiated papillary adenocarcinoma developing in the tubulovillous adenoma of choledochal cyst with papillomatous area. Monthly follow-up for the last 9 months had been normal......

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425767/
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