Two Cases of Cholangiocarcinoma with Rare Growth Pattern

Not much is known about the orgin and growth of cholangiocarcinoma. We report two cases of cholangiocarcinoma which show rare growth patterns. The first patient is 73 years old male complained of jaundice, and percutaneous transhepatic cholangiography (PTC) revealed obstruction of the hepatic duct. An excised specimen contained two independent stalk-shaped cholangiocarcinomas in the hepatic duct. The second patient 69 years old male complained of fever and lower abdominal pain. PTC revealed cystic dilatation of the left hepatic duct and a vague defect on the cholangiogram, and millet jelly-like mucus was aspirated. An excised specimen contained mucin-producing cholangiocarcinoma cells in the lining of the hepatic duct. In the first patient, tumor remained in the mucosal layer, a rare growth pattern which is the so-called carcinoma in adenoma. The second patient showed a mucinous type of papillary adenocarcinoma located in the mucosa. These two cases showed unusual growth patterns, and led us to take a deep interest in the mechanism of carcinogenesis.