CT findings of cystic duct carcinoma two years before obstructive jaundice

We describe a case of cystic duct carcinoma, the computed tomography findings of which had been incidentally obtained several times over the preceding three years before obstructive jaundice appeared. Under the diagnosis of extrahepatic bile duct carcinoma, a 75-year-old man underwent surgery. Two years before obstructive jaundice appeared, the arterio-portal phase of enhanced computed tomography demonstrated an ovoid mass with peripheral rim enhancement, measuring 1.5 cm in diameter, beside the extrahepatic bile duct. One year later, a repeat enhanced computed tomography consistently showed the ovoid mass with peripheral rim enhancement, and the lower slice of the contiguous computed tomography scan revealed a uniformly enhanced mass compressing the neck of the gallbladder. Four months before obstructive jaundice, the uniformly enhanced mass beside the extrahepatic bile duct markedly infiltrated the surrounding tissues with spicula-formation. At laparotomy, a solid and hard tumor was localized on the right side of the extrahepatic bile duct, in the cholecystic duct and the neck of the gallbladder. Of 29 reported cases fulfilling Farrar's criteria in the English literature other than autopsy cases, computed tomography imaging was only performed in two cases, and the computed tomography findings of cystic duct carcinoma in its early stages, have never been fully described.