Distal cholangiocarcinoma

Case contributed by Dr Ammar Haouimi

Presentation

Obstructive jaundice. Had cholecystectomy 25 years prior.

Patient Data

Age: 60 years
Gender: Female
mri

Dilated intra-and extrahepatic biliary ducts with an intraductal soft tissue mass filling the lumen of the distal common hepatic duct, proximal and mid-portion of the common bile duct and extending to the cystic duct stump. This soft tissue mass elicits a low signal on T1, high signal on T2 and T2 fat sat with progressive enhancement on dynamic postcontrast sequences. A small stone (6 mm) of the distal CBD is noted, well-demonstrated on 3D MRCP source images.

Small periportal lymphadenopathy are noted.

Small bilateral renal cysts with malrotated left kidney.

Case Discussion

MRI features of dilated intra-and extrabiliary ducts with an enhancing soft tissue mass within the extrabiliary ducts (distal CHD, proximal and mid-CBD and cystic duct stump), suggestive of distal (extrahepatic) cholangiocarcinoma (pathologically proven).

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