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A case of primary carcinoma of the cystic duct which is a rare condition in biliary malignancies is reported. A 64-year-old woman was admitted to the hospital because of right hypochondralgia. Laparotomy was carried out under a diagnosis of cholelithiasis and acute cholecystitis. As intraoperative cholangiography revealed a defect in the choledocus, a tumor in the choledocus was detected accidentally. In rapid intraoperative frozen section diagnosis, the tumor was proved adenocarcinoma and a resection of the bile duct with lymph node dissection was added to cholecystectomy. A papillary elastic hard tumor measuring 1.4×1.1cm was found out in the cystic duct in the resected specimen. Microscopically it was moderately differentiated adenocarcinoma infiltrating into the fibromuscular layer of the cystic duct. Carcinoma of the cystic duct presents difficulty in preoperative diagnosis, and is commonly detected only in the course of operation or pathological examination of the resected specimen. In paticular, if the gallbladder is not visualized by cholangiography, preoperative examination and operation should be performed by entertaning a possible existence of carcinoma in the cystic duct.

To identify the characteristics indicative of involvement of occult tumors in the remnant breast on breast conservative surgery, we clinicopathologically examined the breast tumors and tissues surrounding the tumors in unilateral breast cancer with gross multiple tumors at the surgical specimen. Gross multiple tumor was found in 6 out of 98 cases of primary breast cancer (6.1%). Of these 6 cases, 5 cases (83.3%) were classified as intraductal spreading type, 1 case (16.7%) as multicentric type, and none as intramammary metastatic type. Histological type of 5 cases showing intraductal spreading type was either non-invasive intraductal cracinona or papillotubular carcinoma, and in 2 cases of them, component of comedo was found. Additionally, in the tissues surrounding tumors, benign breast diseases were found in 3 cases (50.0%), including atypical hyperplasia in 2 cases. We think that it is useful to know the degree of intraductal spreading, histological type of tumors, existence of comedo component and pathological features of tissues surrounding the tumors for predicting the existence of the occult tumors in the remnant breast on breast conservative surgery.

A case of hemangioma of the spleen which was diagnosed as benign splenic tumor preoperatively is reported.The patient, a 62-year-old woman, was examined for a chief complaint of abdominal and back pain during treatment for rheumatoid arthritis. Current diagnostic imaging modalities including ultra-sonography, computed tomography and celiac angiography revealed a primary tumor in the spleen and the patient underwent standard splencetomy. The spleen was slightly enlarged and showed a hemispheric appearance. The cut surface revealed a capsulated tumor 4.1×3.6 cm in size. The tumor was clearly delineated from the surrounding splenic tissues and the histopathological diagnosis was cavernous hemangioma. The patient made a good postoperative recovery and is currently leading a normal life one year after the operation.Cavernous hemangioma of the spleen is relatively rare and the preoperative diagnosis is naturally very difficult. However recent progress in radiology has made early diagnosis possible.In this report, the detailed preoperative radiological findings are described together with a discussion of the relevant literature.