Usefulness of MR imaging in the postsurgical monitoring of gallbladder cancer in a patient with bile duct cancer that developed 7 years after resection of mucinous adenocarcinoma of the gallbladder

We encountered a case of left hepatic duct cancer that developed 7 years af ter surgical resection of early-stage adenocarcinoma of the gallbladder. A 65-year-old woman was hospitalized with high fever and general fatigue. She also had elevated serum levels of alkaline phosphatase, gamma -glutamyltra nspeptidase., and carbohydrate antigen 19-9, Seven years earlier, she had u ndergone extended cholecystectomy and resection of the extrahepatic bile du ct for early-stage mucinous adenocarcinoma of the gallbladder. Conventional examinations did not reveal any responsible lesions. Magnetic resonance (M R) cholangiography, however, showed a tumor obstructing the left hepatic du ct, and dynamic MR images revealed multiple foci of bacterial abscess in th e liver. Surgically resected tissue again revealed mucinous adenocarcinoma. The present case is rare in that metachronous mucinous adenocarcinoma of t he biliary system occurred after a long interval. This case suggests the us efulness of MR imaging in the postsurgical monitoring of patients with gall bladder carcinoma.