A Case of Primary Angiosarcoma of the Distal Bile Duct

Abstract

A 67-year-old man presented to a previous hospital with upper abdominal pain and anemia and was diagnosed with biliary hemorrhage due to cholecystitis. To control the bleeding, interventional radiology (IVR) was performed, along with a subtotal cholecystectomy and placement of a T-tube in the bile duct. However, the bleeding persisted, and he was referred to our hospital two and a half months after the initial treatment. Upon further evaluation at our facility, he was diagnosed with bleeding from a remnant gallbladder and a hematoma in the common bile duct. A second attempt at IVR was made, but it was ineffective, leading to the decision to perform a remnant cholecystectomy. Despite this, the bleeding continued, prompting a hepaticojejunostomy, which ultimately revealed a diagnosis of distal bile duct angiosarcoma upon final pathological examination. While case reports of gallbladder-origin angiosarcoma are occasionally encountered, reports of distal bile duct-origin angiosarcoma are rare. Here, we present the treatment course and a discussion regarding this case.