case_images: PMC4722045_01
case_images: Abdominal ultrasonography showed two tumors extending into the common bile duct. Doppler ultrasound showed a blood flow signal within the tumor
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case_images: Fig1
case_images: Abdominal ultrasonography revealed a cystic dilatation of the extrahepatic bile duct and two protruding tumors in the lumen of the dilated common bile duct (Fig. 1).
case_images: Abdominal CT showed two enhanced tumors (diameter, 4 cm) in the inferior and middle bile duct. Yellow arrows indicate the tumor locations
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case_images: Fig2
case_images: Abdominal computed tomography (Fig. 2) demonstrated a cyst within the common bile duct measuring 7 cm in diameter and two enhanced tumors measuring 4 cm in diameter located in the inferior bile duct and middle bile duct.
case_images: Magnetic resonance cholangiopancreatography demonstrated a cystic dilatation of the extrahepatic bile duct (Todani's CBD classification: type 4-A)
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case_images: Fig3
case_images: Magnetic resonance cholangiopancreatography (Fig. 3) clearly demonstrated a cystic dilatation of the extrahepatic bile duct (Todani's CBD classification: type 4-A).
case_images: Endoscopic retrograde cholangiopancreatography showed two tumors, and biopsy of one of the tumors confirmed adenocarcinoma
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case_images: Fig4
case_images: Endoscopic retrograde cholangiopancreatography (Fig. 4) also demonstrated a cystic dilatation of the bile duct as well as the presence of two tumors.
case_images: The resected specimen demonstrated tumors in the inferior and middle bile ducts. Arrow indicates the papilla of Vater
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case_images: Fig5
case_images: The resected specimen demonstrated tumors in the inferior and middle bile ducts (Fig. 5).
case_images: a, b Pathological examination revealed a well-differentiated tubular adenocarcinoma in the inferior bile duct (a) (hematoxylin and eosin (H.E., x120) and middle bile duct (b) (H.E., x120)
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case_images: Fig6
case_images: A postoperative histopathologic examination revealed a well-differentiated tubular adenocarcinoma, which entirely remained within the mucosal layer, and no lymph node metastasis was found (Fig. 6).