{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T15:31:03Z","timestamp":1775316663093,"version":"3.50.1"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T00:00:00Z","timestamp":1775260800000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Malignant transformation of choledochal cysts after internal drainage is a known risk, but presentation nearly four decades later is exceptional. We report a case of cholangiocarcinoma developing 38\u00a0years after cystoduodenostomy in a 39-year-old female. Diagnosis was confounded by a periampullary diverticulum, mimicking Lemmel\u2019s syndrome. Multimodal imaging suggested a hilar mass, but endoscopy revealed a large diverticulum. Exploratory laparotomy and frozen section analysis confirmed adenocarcinoma arising from the remnant cyst. The patient underwent complete cyst excision, lymphadenectomy, and Roux-en-Y hepaticojejunostomy. This case underscores two critical lessons: the carcinogenic risk of internal drainage persists indefinitely, necessitating lifelong surveillance; and secondary malignancies can anatomically mimic benign conditions like Lemmel\u2019s syndrome, requiring a high index of suspicion and meticulous surgical management.<\/jats:p>","DOI":"10.1093\/jscr\/rjag223","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T13:03:47Z","timestamp":1773234227000},"source":"Crossref","is-referenced-by-count":0,"title":["Malignant transformation of choledochal cyst 38\u00a0years after cystoduodenostomy mimicking Lemmel\u2019s syndrome: a rare diagnostic pitfall"],"prefix":"10.1093","volume":"2026","author":[{"given":"Thien Lai","family":"Vo","sequence":"first","affiliation":[{"name":"Department of Liver Tumor, Binh Dan Hospital , 371 Dien Bien Phu Street, Ban Co Ward, Ho Chi Minh City 700000 ,","place":["Vietnam"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5325-129X","authenticated-orcid":false,"given":"Hoai Kim","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Liver Tumor, Binh Dan Hospital , 371 Dien Bien Phu Street, Ban Co Ward, Ho Chi Minh City 700000 ,","place":["Vietnam"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ho","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Binh Dan Hospital , 371 Dien Bien Phu Street, Ban Co Ward, Ho Chi Minh City 700000 ,","place":["Vietnam"]},{"name":"General Surgery Department, University of Medicine and Pharmacy at Ho Chi Minh City , 217 Hong Bang Street, Cho Lon Ward, Ho Chi Minh City 700000 ,","place":["Vietnam"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phuoc Thanh","family":"Bui","sequence":"additional","affiliation":[{"name":"Department of Liver Tumor, Binh Dan Hospital , 371 Dien Bien Phu Street, Ban Co Ward, Ho Chi Minh City 700000 ,","place":["Vietnam"]},{"name":"Department of General Surgery, Pham Ngoc Thach University of Medicine, 02 Duong Quang Trung Street, Hoa Hung Ward , Ho Chi Minh City 700000 ,","place":["Vietnam"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thanh Phuoc Cong","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Liver Tumor, Binh Dan Hospital , 371 Dien Bien Phu Street, Ban Co Ward, Ho Chi Minh City 700000 ,","place":["Vietnam"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,4,4]]},"reference":[{"key":"2026040410425055500_ref1","doi-asserted-by":"publisher","first-page":"201","DOI":"10.14701\/ahbps.2016.20.4.201","article-title":"Cholangiocarcinoma in choledochal cyst after cystoenterostomy: how a mistreated choledochal cyst can progress to 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