ஐ.எஸ்.எஸ்.என்: 2475-3181
Cochrane J
Context: Lung cancer is the second most common cancer amongst men and women. Metastatic spread of lung cancer usually involves adrenal glands, bone, brain, liver, and other portions of the lung. The biliary system is rarely affected by metastatic lung cancer via hematogenous spread.
Case: We present a case of 61-year old female who presented with obstructive jaundice secondary to a mass in the common bile duct near the takeoff of the cystic duct. EUS/FNA via rapid cytology identified the mass as an adenocarcinoma initially thought to be cholangiocarcinoma. However, with Immunohistochemical staining was identified as metastatic lung adenocarcinoma.
Conclusion: This is case is one of three reported in the literature with direct metastasis of lung cancer to the common bile duct. Patients with obstructive jaundice secondary to CBD mass and known distant primary cancer should be considered for EUS with FNA and immunohistochemical staining to determine the underlying source of CBD mass.