Intermittent jaundice by tumor emboli from intrahepatic cholangiocarcinoma

Gastroenterology. 1992 Nov;103(5):1669-73. doi: 10.1016/0016-5085(92)91194-9.

Abstract

Free-floating tumor debris or mucobilia as a cause of intermittent obstruction has been described infrequently. A patient with intermittent jaundice caused by tumor emboli from an intrahepatic polypoid mucinous cholangiocarcinoma is presented. Symptoms of intermittent jaundice and midepigastric pain persisted over 5 years despite an initial cholecystectomy and common bile duct exploration before definitive diagnosis and treatment of an hepatic trisegmentectomy (segments II, III, and IV). Intraductal mucin was confirmed intraoperatively and pathologically as the cause of the obstructive jaundice. The patient remains asymptomatic and without evidence of disease more than 5 years postoperatively. This report of a predominantly mucin-producing intrahepatic cholangiocarcinoma details a rare protracted clinical course of intermittent biliary obstruction from mucus emboli and highlights the possibility of long-term survival after complete resection.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenoma, Bile Duct / complications*
  • Adenoma, Bile Duct / diagnostic imaging
  • Adenoma, Bile Duct / pathology
  • Adenoma, Bile Duct / surgery
  • Aged
  • Bile Duct Neoplasms / complications*
  • Bile Duct Neoplasms / diagnostic imaging
  • Bile Duct Neoplasms / pathology
  • Bile Duct Neoplasms / surgery
  • Bilirubin / blood
  • Cholecystectomy
  • Cholestasis, Intrahepatic / etiology*
  • Cholestasis, Intrahepatic / surgery
  • Humans
  • Male
  • Neoplastic Cells, Circulating*
  • Tomography, X-Ray Computed

Substances

  • Bilirubin