Bile Duct Lithiasis Mimicking a Perihilar Cholangiocarcinoma-An Endless Dilemma: A Case Report

Hilar bile duct strictures are mostly caused by malignant lesions. The morphological appearance of perihilar cholangiocarcinomas in various imaging modalities have other malignant and even benign mimics, which pose challenges to an accurate diagnosis and treatment and drive to futile surgery. Herein...

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Veröffentlicht in:Journal of clinical medicine 2023-08, Vol.12 (15), p.5104
Hauptverfasser: Piccino, Marco, Hoxhaj, Ilda, Grossi, Ugo, Romano, Maurizio, Brizzolari, Marco, Scopelliti, Michele, Finotti, Michele, Zanus, Giacomo
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container_issue 15
container_start_page 5104
container_title Journal of clinical medicine
container_volume 12
creator Piccino, Marco
Hoxhaj, Ilda
Grossi, Ugo
Romano, Maurizio
Brizzolari, Marco
Scopelliti, Michele
Finotti, Michele
Zanus, Giacomo
description Hilar bile duct strictures are mostly caused by malignant lesions. The morphological appearance of perihilar cholangiocarcinomas in various imaging modalities have other malignant and even benign mimics, which pose challenges to an accurate diagnosis and treatment and drive to futile surgery. Herein, we present the case of a 50-year-old woman admitted with jaundice and abdominal pain, elevated bilirubin level, liver function tests and carbohydrate antigen 19-9 level. Magnetic resonance cholangio-pancreatography (MR-CP) and the computed tomography with contrast enhancement revealed a suspected extrahepatic cholangiocarcinoma of the common bile duct. Further spontaneous resolution of the scenario, confirmed by diagnostic assessment, changed the clinical hypothesis in favor of a non-oncological disease. Indeed, the multidisciplinary evaluation supported a diagnosis of transient cholangitis secondary to non-evident intrahepatic lithiasis rather than cholangiocarcinoma. After a 26-month follow-up, the patient was asymptomatic with normal tumor markers and laboratory data. Consecutive MR-CPs showed no suspicion of malignancy. This case report underlines the need for an accurate preoperative assessment in patients with suspected cholangiocarcinoma.
doi_str_mv 10.3390/jcm12155104
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The morphological appearance of perihilar cholangiocarcinomas in various imaging modalities have other malignant and even benign mimics, which pose challenges to an accurate diagnosis and treatment and drive to futile surgery. Herein, we present the case of a 50-year-old woman admitted with jaundice and abdominal pain, elevated bilirubin level, liver function tests and carbohydrate antigen 19-9 level. Magnetic resonance cholangio-pancreatography (MR-CP) and the computed tomography with contrast enhancement revealed a suspected extrahepatic cholangiocarcinoma of the common bile duct. Further spontaneous resolution of the scenario, confirmed by diagnostic assessment, changed the clinical hypothesis in favor of a non-oncological disease. Indeed, the multidisciplinary evaluation supported a diagnosis of transient cholangitis secondary to non-evident intrahepatic lithiasis rather than cholangiocarcinoma. 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subjects Abdomen
Analysis
Anticoagulants
Antigens
Bile ducts
Biomarkers
Blood tests
Case Report
Case reports
Cholangiocarcinoma
Cholangitis
Clinical medicine
Complications and side effects
CT imaging
Enzymes
Gallstones
Hepatectomy
Leukocytes
Liver
Metastasis
Pancreatitis
Patients
Thrombosis
Ultrasonic imaging
Veins & arteries
title Bile Duct Lithiasis Mimicking a Perihilar Cholangiocarcinoma-An Endless Dilemma: A Case Report
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