Abstract:
Background: Bile duct carcinoma is an extremely aggressive and rare primary hepatobiliary malignancy affecting nearly 1-2/100,000 people
in most countries in Europe. Biliary tract malignancies located in the distal third of the common bile duct (CBD) account for approximately
17-18% of all cholangiocarcinomas. This report aims to provide a step-by-step evaluation of a rare case of cholangiocarcinoma.
Content: The current report focuses on a 65-year-old male patient who was presented to the emergency department with signs and symptoms
suggestive for a biliary tract obstruction. An intense cooperation between multiple departments was required in order to perform a complete
and accurate evaluation of the patient. Initially, the patient underwent an abdominal Ultrasonography (US), followed by an abdominal and
pelvic Computed Tomography (CT), which revealed an intraductal tumor affecting the distal CBD. Furthermore, the patient underwent an
endoscopic retrograde cholangiopancreatography (ERCP) in order to provide tissue samples and to perform a dilatation of the CBD in the
affected area. The histopathology report confirmed the malignant nature of the lesion describing it as an adenocarcinoma. The surgeons
performed a pancreaticoduodenectomy (Whipple procedure), managing to achieve negative tumor resection margins. However, the patient
developed several complications that required multiple surgical reinterventions.
Conclusions: This report presents a fully investigated less common type of cholangiocarcinoma, highlighting the principles of diagnosis
and management as well as of a multidisciplinary approach in such patients.
Description:
Department of Radiology and Medical Imaging, Department of Rheumatology, Departament of Gastroenterology, University of Medicine and Pharmacy of Craiova, Craiova, Romania, The IVth Congress of Radiology and Medical Imaging of the Republic of Moldova with international participation, Chisinau, May 31 – June 2, 2018