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[Jaundice due to a rare cause: detection through systematic analysis].
Veerle L E Doornebosch1,2, Joop van Baarlen3, Niels G Venneman1
1Medisch Spectrum Twente, afd. Maag-, Darm en Leverziekten, Enschede.
Nederlands Tijdschrift Voor Geneeskunde
|May 2, 2022
Summary
Jaundice, a symptom of cholestasis, can stem from various causes. This case highlights melanoma metastasis to the common bile duct as a rare but critical diagnosis.
Area of Science:
- Gastroenterology
- Oncology
- Pathology
Background:
- Jaundice is a common clinical sign indicating cholestasis, necessitating a broad differential diagnosis.
- Determining the location of cholestasis (intrahepatic, hepatic, or extrahepatic) is crucial for accurate diagnosis.
Observation:
- A 61-year-old male presented with jaundice and dilated intrahepatic and common bile ducts on ultrasound, initially suspected to be a sludge ball.
- Endoscopic retrograde cholangiopancreatography (ERCP) revealed a mass in the common bile duct, not a gallstone.
Findings:
- Histological examination confirmed the mass as a metastasis of melanoma.
- Dermatological examination identified a primary melanoma on the patient's chest.
Implications:
- This case underscores the importance of considering uncommon causes of biliary obstruction, including metastatic disease.
- A systematic diagnostic approach is vital for identifying rare conditions like common bile duct melanoma metastasis promptly.
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