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Painless Jaundice Caused by Metastatic Renal Cell Carcinoma to the Distal Common Bile Duct.

Omar H, Ly C, Qazi B, Chi K - ACG Case Rep J (2015)

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Advocate Lutheran General Hospital, Park Ridge, IL.

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There was intra- and extrahepatic biliary dilation with gallbladder distention secondary to common bile duct (CBD) calculus... A magnetic resonance cholangiopancreatography (MRCP) showed a filling defect in the distal common bile duct with biliary dilation and a large heterogeneous mass in the left kidney extending into the pararenal fat without evidence of vascular invasion (Figure 1)... Endoscopic retrograde cholangiopancreatography (ERCP) showed a dilated common bile duct (12 mm) with a distal mobile filling defect as well as a separate fixed filling defect mimicking a stone... Our patient's MRCP showed that the intraluminal filling defect had slight contrast enhancement, suggesting vascular tumor consistent with RCC rather than calculi... Intraluminal metastasis of the distal CBD without synchronous liver involvement is a rare cause of painless, obstructive jaundice, but should be suspected in a patient with a history of RCC... Author contributions: All authors contributed equally to the writing and editing of the manuscript... Omar is the article guarantor... Financial disclosure: None to report... Informed consent was obtained for this case report.

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Related in: MedlinePlus

MRCP showing a filling defect in the distal common bile duct with biliary dilation.
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Figure 1: MRCP showing a filling defect in the distal common bile duct with biliary dilation.

Mentions: A magnetic resonance cholangiopancreatography (MRCP) showed a filling defect in the distal common bile duct with biliary dilation and a large heterogeneous mass in the left kidney extending into the pararenal fat without evidence of vascular invasion (Figure 1). Endoscopic retrograde cholangiopancreatography (ERCP) showed a dilated common bile duct (12 mm) with a distal mobile filling defect as well as a separate fixed filling defect mimicking a stone. After sphincterotomy, 2 stones were removed. Repeat cholangiogram revealed a persistent distal CBD stricture approximately 2 cm in length (Figure 2). Brush biopsies showed clear cell renal cell carcinoma (RCC; Pax-8 and CD10 positive).


Painless Jaundice Caused by Metastatic Renal Cell Carcinoma to the Distal Common Bile Duct.

Omar H, Ly C, Qazi B, Chi K - ACG Case Rep J (2015)

MRCP showing a filling defect in the distal common bile duct with biliary dilation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508941&req=5

Figure 1: MRCP showing a filling defect in the distal common bile duct with biliary dilation.
Mentions: A magnetic resonance cholangiopancreatography (MRCP) showed a filling defect in the distal common bile duct with biliary dilation and a large heterogeneous mass in the left kidney extending into the pararenal fat without evidence of vascular invasion (Figure 1). Endoscopic retrograde cholangiopancreatography (ERCP) showed a dilated common bile duct (12 mm) with a distal mobile filling defect as well as a separate fixed filling defect mimicking a stone. After sphincterotomy, 2 stones were removed. Repeat cholangiogram revealed a persistent distal CBD stricture approximately 2 cm in length (Figure 2). Brush biopsies showed clear cell renal cell carcinoma (RCC; Pax-8 and CD10 positive).

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Advocate Lutheran General Hospital, Park Ridge, IL.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

There was intra- and extrahepatic biliary dilation with gallbladder distention secondary to common bile duct (CBD) calculus... A magnetic resonance cholangiopancreatography (MRCP) showed a filling defect in the distal common bile duct with biliary dilation and a large heterogeneous mass in the left kidney extending into the pararenal fat without evidence of vascular invasion (Figure 1)... Endoscopic retrograde cholangiopancreatography (ERCP) showed a dilated common bile duct (12 mm) with a distal mobile filling defect as well as a separate fixed filling defect mimicking a stone... Our patient's MRCP showed that the intraluminal filling defect had slight contrast enhancement, suggesting vascular tumor consistent with RCC rather than calculi... Intraluminal metastasis of the distal CBD without synchronous liver involvement is a rare cause of painless, obstructive jaundice, but should be suspected in a patient with a history of RCC... Author contributions: All authors contributed equally to the writing and editing of the manuscript... Omar is the article guarantor... Financial disclosure: None to report... Informed consent was obtained for this case report.

No MeSH data available.


Related in: MedlinePlus