Quiste de colédoco tipo I asociado a adenocarcinoma

Adenocarcinoma case of choledochal cyst with duodenal invasion, 16 years surveillance. Literature revision. Background: Choledochal cysts are more common in women; 20% diagnosed in adults. The most common ones are I and IV (Todani). There is a relation with lithiasis in cyst, calculous cholecystitis; pancreatitis and cancer; with prevalent in type I and IV (57% is intracystic). From unknown etiology, diagnostic is clinic with USG, ERCP, resection treatment with biliodigestive reconstruction, a rare long-term surveillance. Description: 41 years old woman with acute abdomen, operated on November 1991 finding: chronic calculous cholecystitis, biliary dilatation due to choledocholithiasis. The surgery was cholecystectomy, biliar exploration and choledocho-duodenostomy anastomosis. Reentered June 1992, with acute abdomen and jaundice. USG and CPRE are performed, upholding cyst type I. Operated on finding: choledochal saccular, internal polypoid tumor and choledochoduodenostomy with stenosis. The treatment: cystic resection with «Y»of Roux rebuilt and catheter placement. Chemotherapy at month altogether with USG, TAC and scintigran with 99Tc-IDA. No tumor activity currently. Conclusion: Surveillance is a long-term rare. Resection with chemotherapy might rise or diminish the recidivium.