This patient presented with abdominal pain of the upper quadrant and dark urine. Ultrasonic imaging showed a slight dilatation of the common hepatic duct (CHD) of maximum of 8 mm. The ERCP showed a distal carinoma-like CHD-stenosis, a stent was applied. Past history of renal cell carcinoma (RCC) of the right kidney with nephrectomy on 01/2013 pT3b Nx Mx V1 R1. Lung-metastases 05/2014. Start of chemotherapy with Pazopanib from 05/08/2014.