Biliary epithelial metastasis of squamous carcinoma of the anus

The liver and biliary tree are common sites of initial metastasis for many primary tumors. However, we recently encountered a patient who presented with biliary-tree tumor encasement as a first metastasis from squamous carcinoma of the anus.

To our knowledge, this has not been previously described in the literature.

As obstructive jaundice is a relatively common presenting sign in the emergency room and in general surgical clinics, we thus recommend early consideration of metastatic disease as a differential diagnosis in patients post-chemoradiotherapy for anal carcinoma who present with obstructive jaundice.