A CASE OF LOCALIZED PRIMARY SCLEROSING CHOLANGITIS MIMICKING BILE DUCT CANCER

Abstract

A 63-year-old man was admitted to the hospital because of upper abdominal pain, back pain, and slight fever. On imaging methods, diffuse dilatation of the intrahepatic bile ducts in the left lobe was confirmed, and among them, abdominal ultrasonography demonstrated a tumor-like lesion at the proximal side of the dilated bile duct in the left lobe. Choledochography disclosed strictures of the bile ducts and dispersed dilatations of them. With a suspected diagnosis of cholangiocellular carcinoma, a left lobectomy was performed. Histopathological examination of the resected specimen, however, showed primary sclerosing cholangitis (PSC) and no malignant lesion. It is sometimes extremaly difficult to differentiate localized PSC from bile duct cancer, but it is desirable to treat localized PSC by surgical resection because it would provide good prognosis and association of bile duct cancer is probable.