Clinicopathological analysis of cystic duct carcinoma

Background/Aims: Gallbladder carcinoma is the most common malignancy of the biliary tract, while the clinical features of cystic duct carcinoma remain unexplored. Methodology: Clinicopathological data of 8 cases of cystic duct carcinoma were retrospectively analyzed. Results: The sample included 5 men and 3 women, with a mean age of 66 ± 10 years (range, 49-79 years). Clinical manifestations included jaundice (n=6) and/or abdominal pain (n=6). Two of the patients presented as acute cholecystitis. Preoperative workups included ultrasonography (n=8), computed tomography (n=7), and endoscopic retrograde cholangiography (n=6)/or magnetic resonance cholangiography (n=2). Meanwhile, the preoperative diagnoses included cystic duct neoplasms (n=3), common hepatic duct neoplasms (n=4), and gallstones with acute cholecystitis (n=1). Radical procedures, including cholecystectomy, resection of extrahepatic bile duct, and lymph node dissection, were performed in six patients, while palliative cholecystectomy was performed in the remaining two. Notably, five of eight cases displayed lymph node metastasis along the hepaticoduodenal ligament. Median survival was 15 months (range, 6 to 26 months). Two cases with no lymph node metastasis were alive and disease free at 23 months and 26 months, respectively. Conclusions: Cystic duct carcinoma is rare. Neoplasm of the cystic duct should be suspected in patients presenting with cystic duct obstruction accompanied by distended nonfunctioning gallbladder without evidence of stone impaction in the cystic duct. The prognosis of cystic duct carcinoma remains dismal. However, for those patients in whom tumors are detected in early stage, curative radical resections possibly provide the chance of potential curable.