Neuroendocrine carcinoma developing in a choledochal cyst.

A 57-year-old woman was evaluated for a 2-month history f abdominal pain, weight loss. There was no history of fever or aundice. Physical examination revealed mild tenderness in the allbladder area. Laboratory values (e.g., bilirubin) and tumour arkers (CA 19-9, AFP, CEA) were all within normal limits. Abdomnal ultrasonography showed dilatation of the extrahepatic bile uct. Contrast-enhanced abdominal magnetic resonance imaging howed a type-I choledochal cyst (5 cm × 7 cm) and a terminal lling defect with enhancement (Fig. 1; up and down arrow). Endocopic retrograde cholangiopancreatography was attempted but ailed. The patient underwent an exploratory laparotomy. A grey