A case of carcinoma arising in the intrapancreatic terminal choledochus 12 years after primary excision of a giant choledochal cyst

A 27-yr-old woman with carcinoma developing in the intrapancreatic terminal choledochus 12 yr after the initial excision of giant choledochal cyst with Roux-en-Y hepaticojejunostomy is reported. Despite the generally accepted concept that the presence of bile is associated with malignancy in the remnant biliary ducts after excision of a choledochal cyst, this is the first report of a malignant growth developing in the terminal choledochus which had been free from the bile exposure long after the excision of the choledochal cyst. Long-term follow-up of the patient is advisable even after operation for primary resection of the choledochal cyst.