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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MDPI AG
2023-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/15/5104 |
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| author | Marco Piccino Ilda Hoxhaj Ugo Grossi Maurizio Romano Marco Brizzolari Michele Scopelliti Michele Finotti Giacomo Zanus |
| author_facet | Marco Piccino Ilda Hoxhaj Ugo Grossi Maurizio Romano Marco Brizzolari Michele Scopelliti Michele Finotti Giacomo Zanus |
| author_sort | Marco Piccino |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-11T00:24:00Z |
| format | Article |
| id | doaj.art-fa2345d54d5047c1b5e8c1bdcba9fe10 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T00:24:00Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-fa2345d54d5047c1b5e8c1bdcba9fe102023-11-18T23:09:27ZengMDPI AGJournal of Clinical Medicine2077-03832023-08-011215510410.3390/jcm12155104Bile Duct Lithiasis Mimicking a Perihilar Cholangiocarcinoma—An Endless Dilemma: A Case ReportMarco Piccino0Ilda Hoxhaj1Ugo Grossi2Maurizio Romano3Marco Brizzolari4Michele Scopelliti5Michele Finotti6Giacomo Zanus72nd Surgery Unit, “Ca’ Foncello” Regional Hospital, 31100 Treviso, Italy2nd Surgery Unit, “Ca’ Foncello” Regional Hospital, 31100 Treviso, Italy2nd Surgery Unit, “Ca’ Foncello” Regional Hospital, 31100 Treviso, Italy2nd Surgery Unit, “Ca’ Foncello” Regional Hospital, 31100 Treviso, Italy2nd Surgery Unit, “Ca’ Foncello” Regional Hospital, 31100 Treviso, Italy2nd Surgery Unit, “Ca’ Foncello” Regional Hospital, 31100 Treviso, Italy2nd Surgery Unit, “Ca’ Foncello” Regional Hospital, 31100 Treviso, Italy2nd Surgery Unit, “Ca’ Foncello” Regional Hospital, 31100 Treviso, ItalyHilar 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.https://www.mdpi.com/2077-0383/12/15/5104case reportcholangiocarcinomaintrahepatic lithiasis |
| spellingShingle | Marco Piccino Ilda Hoxhaj Ugo Grossi Maurizio Romano Marco Brizzolari Michele Scopelliti Michele Finotti Giacomo Zanus Bile Duct Lithiasis Mimicking a Perihilar Cholangiocarcinoma—An Endless Dilemma: A Case Report Journal of Clinical Medicine case report cholangiocarcinoma intrahepatic lithiasis |
| title | Bile Duct Lithiasis Mimicking a Perihilar Cholangiocarcinoma—An Endless Dilemma: A Case Report |
| title_full | Bile Duct Lithiasis Mimicking a Perihilar Cholangiocarcinoma—An Endless Dilemma: A Case Report |
| title_fullStr | Bile Duct Lithiasis Mimicking a Perihilar Cholangiocarcinoma—An Endless Dilemma: A Case Report |
| title_full_unstemmed | Bile Duct Lithiasis Mimicking a Perihilar Cholangiocarcinoma—An Endless Dilemma: A Case Report |
| title_short | Bile Duct Lithiasis Mimicking a Perihilar Cholangiocarcinoma—An Endless Dilemma: A Case Report |
| title_sort | bile duct lithiasis mimicking a perihilar cholangiocarcinoma an endless dilemma a case report |
| topic | case report cholangiocarcinoma intrahepatic lithiasis |
| url | https://www.mdpi.com/2077-0383/12/15/5104 |
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