22 January 2018 : Case report
Atypical Presentation of a Rare Disease: Eosinophilic Cholangitis Posing as a Cancer
Challenging differential diagnosis, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Judie Noemie Hoilat1ABDEF*, Gilles Jad Hoilat1ABDEF, Saeed AlQahtani2ABDF, Hussah F. Alhussaini3BDEF, Saleh I. Alabbad2ABDEFDOI: 10.12659/AJCR.906130
Am J Case Rep 2018; 19:76-81
Abstract
BACKGROUND: A variety of benign etiologies of biliary stricture may initially be mistaken for hilar cholangiocarcinoma. Consequently, many patients undergo surgery for a benign disease that could have been treated medically. Eosinophilic cholangitis (EC) is an uncommon, benign, self-limiting disease that should be considered when approaching a case of obstructive jaundice since it causes biliary stricture formation. Transmural eosinophilic infiltration of the biliary tree is characteristic of EC. It may initially be indistinguishable from hilar cholangiocarcinoma.
CASE REPORT: We present a rare case of an 84-year-old male who was referred to our hospital for abdominal mass investigation with the provisional diagnosis of cholangiocarcinoma. During the workup, the index of suspicion for malignancy remained high as the typical laboratory and radiological findings for benign causes of biliary stricture were not present. Hence, the patient underwent left hepatectomy with caudate lobe resection and received a retrograde diagnosis of EC.
CONCLUSIONS: This case demonstrates that EC could present in the elderly with cardinal signs of cancer and absence of the typical findings of EC which was not previously reported. Since only 70% of patients present with peripheral eosinophilia, we stress on the importance of implementing diagnostic criteria for EC in the setting where peripheral eosinophilia is absent. Furthermore, this disorder has been reported to respond well to steroid therapy, hence, diagnostic criteria for EC would provide another treatment option for elderly and/or those who are not fit for surgery.
Keywords: Bile Duct Diseases, Cholangitis, Constriction, Pathologic
In Press
Case report
Concurrent Diagnosis of Chronic Lymphocytic Leukemia and Plasma Cell Myeloma: Report of 2 Cases and Differe...Am J Case Rep In Press; DOI: 10.12659/AJCR.944707
Case report
“No-Touch” Saphenous Vein Grafting and Coronary Aneurysm Ligation in an Adult Patient with Suspected Prior ...Am J Case Rep In Press; DOI: 10.12659/AJCR.945431
Case report
Unexpected Chylous Ascites During Umbilical Hernia Repair in a Patient with Necrotizing Pancreatitis: A Cas...Am J Case Rep In Press; DOI: 10.12659/AJCR.944609
Case report
A Rare Complication of Cannabinoid Hyperemesis SyndromeAm J Case Rep In Press; DOI: 10.12659/AJCR.945106
Most Viewed Current Articles
21 Jun 2024 : Case report 57,146
Intracranial Parasitic Fetus in a Living Infant: A Case Study with Surgical Intervention and Prognosis Anal...DOI :10.12659/AJCR.944371
Am J Case Rep 2024; 25:e944371
07 Mar 2024 : Case report 42,303
Neurocysticercosis Presenting as Migraine in the United StatesDOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
10 Jan 2022 : Case report 32,415
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
23 Feb 2022 : Case report 19,841
Penile Necrosis Associated with Local Intravenous Injection of CocaineDOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250