A case of distal biliary obstruction due to metastases of peri-pancreatic lymph nodes caused by pulmonary adenocarcinoma, who was successfully treated by new chemotherapy with immune checkpoint inhibitors

Abstract

A 53-years-old female was admitted to our hospital with dyspnea and liver dysfunction. A chest CT scan showed a lung tumor with right supraclavicular and mediastinal lymph node swelling. Abdominal CT scan revealed peri-pancreatic tumor with distal biliary obstruction. Pathological examination of a transbronchial biopsy specimen and an endoscopic biopsy bile duct specimen revealed metastases of peri-pancreatic lymph nodes caused by pulmonary adenocarcinoma. Since obstructive jaundice was prominent, she received EBD, and jaundice was improved, chemotherapy (carboplatin,pemetrexed, pembrolizumab) was started. She is now on chemotherapy for pulmonary adenocarcinoma as of 18 months after the diagnosis.