Challenges in diagnosing and managing cystic duct carcinoma: A case report from Syria - Case report

Sep 28, 2026

Primary cystic duct carcinoma is a rare, aggressive biliary malignancy that creates major diagnostic and therapeutic difficulties in routine practice. The case report describes a 57-year-old man with severe right upper abdominal pain, jaundice, and altered stool color. Imaging revealed inflammatory gallbladder stones without biliary dilation. Histopathology confirmed ulcerated papillary adenocarcinoma invading the gallbladder layers, with tumor-free lymph nodes and chronic portitis, supporting a cystic duct carcinoma diagnosis. The authors emphasize a multidisciplinary strategy from diagnosis to surgical management.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Introduction

Case presentation

Clinical discussion

Conclusion

International Journal of Surgery Case Reports 114 (2024) 109110 Contents lists available at ScienceDirect International Journal of Surgery Case Reports journal [homepage:](homepage: www.elsevier.com/locate/ijscr)[ www.elsevier.com/locate/ijscr](homepage: www.elsevier.com/locate/ijscr) | Case report
Challenges in diagnosing and managing cystic duct carcinoma: A case report from Syria
Mohammed Jomaaa, Jamal Ataya b, *, Rand Hamedc, Ali Alshiekh d, Muhammad Fadi Alkurdie, Hamoud Hamedf
a Department of General and Laparoscopic Surgery, Faculty of Medicine, Damascus University, Damascus, Syria b Faculty of Medicine, University of Aleppo, Aleppo, Syria
c Faculty of Medicine, Damascus University, Damascus, Syria
d General Surgery, Faculty of Medicine, Damascus University, Damascus, Syria e General Surgery, Faculty of Medicine, Damascus University, Damascus, Syria
f General and Laparoscopic Surgery, Faculty of Medicine, Damascus University, Damascus, Syria | | | | --- | --- | --- | | A R T I C L E I N F O | | A B S T R A C T | | Keywords: Adenocarcinoma Common bile duct Case report
Primary cystic duct carcinoma Syria | | Introduction and importance: Primary cystic duct carcinoma, an uncommon and aggressive biliary cancer variant, poses a significant challenge in clinical practice. This study examines recent clinical cases, focusing on diagnostics, interventions, and implications in managing this disease, with a prevalence ranging from 0.03 % to 0.05 %, contributing to 2.6–12.6 % of extrahepatic biliary neoplasms.
Case presentation: A 57-year-old male, a smoker with hypertension and hyperuricemia, presented symptoms of severe upper right abdominal pain, jaundice, and altered stool color. Diagnosis revealed ulcerated papillary adenocarcinoma invading all gallbladder layers (2.5 cm). Surgical resection and Roux-en-Y anastomosis were performed. Histopathological examination showed invasive tumor proliferation, preserved lymph node architecture, and severe hepatic microsteatosis. Lymph nodes were tumor-free, and a benign hepatic biopsy (0.5 cm) displayed chronic portitis. The final diagnosis confirmed cystic duct carcinoma, emphasizing the complex diagnostic and therapeutic aspects in biliary cases.
Clinical discussion: The clinical discussion unveils the complexities associated with primary cystic duct carcinomas. Emphasizing the necessity of a multidisciplinary approach, this case highlights the importance of efficient management strategies—from initial diagnosis to surgical intervention—in dealing with this challenging malignancy.
Conclusion: In conclusion, this case underscores the intricate nature of primary cystic duct carcinomas. It accentuates the essential role of a multidisciplinary approach, urging the need for continuous research endeavors to further comprehend and enhance the treatment methodologies for this rare and complex malignancy. | 1. Introduction The field of oncology is witnessing the emergence of a unique entity, carcinoma of the cystic duct, which is a rare and aggressive cancer variant within the biliary system. The propensity for localized invasion and extensive metastasis requires rigorous investigation. This analysis comprehensively examined recent clinical cases, addressing diagnostic challenges, strategic interventions, and clinical implications. Primary cystic duct carcinoma is a rare type of cancer that arises within a narrow range of prevalence (0.03–0.05 %) and holds a significant position among extrahepatic biliary neoplasms (2.6–12.6 % incidence), as determined by Farrar's diagnostic criteria [1–3]. Gastrointestinal malignancies reveal extrahepatic biliary duct pathologies (2–3.6 % incidence), where primary cystic duct carcinoma arises as an enigmatic entity, documented in fewer than 70 cases worldwide since 2017 [4]. With a preference in East Asia and scarcity in the Indian subcontinent, we present a case of laparoscopic cholecystectomy [4]. Earliеr class

FAQs

What makes primary cystic duct carcinoma clinically challenging?

Its rarity and aggressive behavior lead to substantial diagnostic difficulty and complex decision-making regarding interventions and treatment planning.

What were the main presenting symptoms in the reported case?

The patient presented with severe upper right abdominal pain, jaundice, and altered stool color, along with nausea.

How was the diagnosis and management approached in this case?

The workup used emergency labs and imaging, followed by surgical resection with Roux-en-Y anastomosis. Histopathology confirmed cystic duct carcinoma and highlighted the need for efficient multidisciplinary management.

Sep 28, 2026

Uploaded by Anna Hans