Occult mucin-producing cholangiocarcinoma in situ: a rare clinical case with difficult tumour staging

A rare case report of obstructive jaundice caused by mucus-producing cholangiocarcinoma

RATIONALE

Cholangiocarcinoma is a common cause of obstructive jaundice but is mainly associated with solid mass and not semisolid secretion. In this report, the patient was admitted to the hospital with obstructive jaundice; however, no solid mass was found to lead to jaundice.

PATIENT CONCERNS

The patient developed symptoms of obstructive jaundice for 10 days, including fatigue and yellow skin staining.

DIAGNOSES

Postoperative pathological examination of the bile duct wall revealed cholangioadenocarcinoma, and the jelly like contents were inflammatory secretions.

INTERVENTIONS

The patient underwent laparotomy and was diagnosed with obstructive jaundice. An exploratory laparotomy revealed that the content in the biliary duct tree was a jelly like inflammatory secretion.

OUTCOMES

Follow-up data revealed that the levels of total bilirubin and aminotransferase were normal, and a computed tomography scan showed no tumor mass.

LESSONS

There are very few reports about obstructive jaundice caused by inflammatory secretion that almost filled up the biliary tree. Internal drainage of the cholestatic bile can be achieved through endoscopic retrograde cholangiopancreatograpy, or external drainage can be achieved through percutaneous transhepatic biliary drainage, which can relieve the symptoms of biliary obstruction and improve the patient's quality of life.