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DOI: 10.1055/s-2007-971179
Hilar Biliary Obstruction: Malignant Masquerades
Publication History
Publication Date:
27 March 2007 (online)
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ABSTRACT
Biliary obstruction at the hepatic hilus is most often due to malignancy. Clinically, it can be very difficult to differentiate malignant from benign obstruction when a mass lesion is not evident on cross-sectional imaging. In this article, we describe three cases of benign biliary obstruction due to so-called malignant masquerades to familiarize the reader with the clinical, radiographic, and pathological features of these uncommon but important entities.
KEYWORDS
Biliary obstruction - autoimmune pancreatitis - chemotherapy-induced biliary sclerosis - Clonorchis sinensis
REFERENCES
- 1 Principe A, Ercolani G, Paolucci U et al.. Diagnostic dilemmas in biliary strictures mimicking cholangiocarcinoma. Hepatogastroenterology. 2003; 50 1246-1249
- 2 Corvera C U, Blumgart L H, Darvishian F et al.. Clinical and pathologic features of proximal biliary strictures masquerading as hilar cholangicarcinoma. J Am Coll Surg. 2005; 201 862-869
- 3 Weber S M, Cubukcu-Dimopulo O, Palesty J A et al.. Lymphoplasmacytic sclerosing pancreatitis: inflammatory mimic of pancreatic carcinoma. J Gastrointest Surg. 2003; 7 129-137
- 4 Kim K P, Kim M H, Kim J C, Lee S S, Seo D W, Lee S K. Diagnostic criteria for autoimmune chronic pancreatitis revisited. World J Gastroenterol. 2006; 12 2487-2496
- 5 Kamisawa T, Egawa N, Nakajima H, Tsuruta K, Okamoto A, Kamata N. Clinical difficulties in the differentiation of autoimmune pancreatitis and pancreatic carcinoma. Am J Gastroenterol. 2003; 98 2694-2699
- 6 Hamano H, Kawa S, Horiuchi A et al.. High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med. 2001; 344 732-738
- 7 Fukui T, Okazaki K, Yoshizawa H et al.. A case of autoimmune pancreatitis associated with sclerosing cholangitis, retroperitoneal fibrosis and Sjogren's syndrome. Pancreatology. 2005; 5 86-91
- 8 Cohen A D, Kemeny N E. An update on hepatic arterial infusion chemotherapy for colorectal cancer. Oncologist. 2003; 8 553-566
- 9 Kemeny N, Huang Y, Cohen A M et al.. Hepatic arterial infusion of chemotherapy after resection of hepatic metastases from colorectal cancer. N Engl J Med. 1999; 341 2039-2048
- 10 Aldrighetti L, Arru M, Ronzoni M et al.. Extrahepatic biliary stenosis after hepatic arterial infusion (HAI) of floxuridine (FUdR) for liver metastases from colorectal cancer. Hepatogastroenterology. 2001; 48 1302-1307
- 11 Martin R C, Edwards M J, McMasters K M. Morbidity of adjuvant hepatic arterial infusion pump chemotherapy in the management of colorectal cancer metastatic to the liver. Am J Surg. 2004; 188 714-721
- 12 Brown K T, Kemeny N, Berger M F et al.. Obstructive jaundice in patients receiving hepatic artery infusional chemotherapy: etiology, treatment implications, and complications after transhepatic biliary drainage. J Vasc Interv Radiol. 1997; 8 229-234
- 13 Ensminger W, Knol J, DeRemer S et al.. Effects of dexamethasone or celecoxib on biliary toxicity after hepatic arterial infusion of 5-fluorodeoxyuridine in a canine model. Cancer Res. 2004; 64 311-315
- 14 Kemeny N, Seiter K, Niedzqiecki D et al.. A randomized trial of intrahepatic infusion of fluorodeoxyuridine with dexamethasone versus fluorodeoxyuridine alone in the treatment of metastatic colorectal cancer. Cancer. 1992; 69 327-334
- 15 Shea Jr W J, Demas B E, Goldberg H I et al.. Sclerosing cholangitis associated with hepatic arterial FUDR chemotherapy: radiographic-histologic correlation. AJR Am J Roentgenol. 1986; 146 717-721
- 16 Hohn D, Melnick J, Stagg R et al.. Biliary sclerosis in patients receiving hepatic arterial infusions of floxuridine. J Clin Oncol. 1985; 3 98-102
- 17 Liao W C, Wang H P, Chiu H M, Chang C Y, Lin J T. Multiple hepatic nodules: rare manifestation of clonorchiasis. J Gastroenterol Hepatol. 2006; 21 1497-1500
- 18 Choi B I, Han J K, Hong S T, Lee K H. Clonorchiasis and cholangiocarcinoma: etiologic relationship and imaging diagnosis. Clin Microbiol Rev. 2004; 17 540-552
- 19 Binkley C E, Eckhauser F E, Colletti L M. Unusual causes of benign biliary strictures with cholangiographic features of cholangiocarcinoma. J Gastrointest Surg. 2002; 6 676-681
Anne M CoveyM.D.
Department of Radiology, Memorial Sloan-Kettering Cancer Center
1275 York Avenue, Room H201, New York, NY 10021