ASGE Postgraduate Course at ACG 2022: Expanding the Scope of Fundamental and Advanced Endoscopy

Muthusamy_CASE Session 3

Pdf Summary

In this session, Dr. V. Raman Muthusamy presented two cases related to biliary strictures. In Case 1, a 71-year-old woman with breast cancer metastatic to bone presented with epigastric pain and elevated liver tests. Magnetic resonance cholangiopancreatography showed a stricture in the common bile duct, and previous endoscopic procedures were inconclusive. Repeat ERCP revealed a smooth stricture, and cholangioscopy with expanded capacity forceps obtained biopsies that showed atypical epithelial cells in an inflamed stroma suspicious for adenocarcinoma. Special stains confirmed it as an intramural bile duct breast cancer metastasis. This case demonstrates the clinical utility of improved cholangioscopic tools for accurate diagnosis and treatment.<br /><br />Case 2 involved a video of a patient with cholangiocarcinoma undergoing stenting and biliary RFA (radiofrequency ablation). Further details about the case were not provided.<br /><br />Overall, these cases highlighted the importance of using advanced endoscopic techniques, such as cholangioscopy, to improve diagnostic accuracy and guide appropriate treatment for biliary strictures. It also emphasized the need for considering atypical metastases, like breast cancer, in the differential diagnosis of biliary lesions.

Keywords

biliary strictures

breast cancer metastasis

epigastric pain

common bile duct

endoscopic procedures

cholangioscopy

adenocarcinoma

cholangiocarcinoma

stenting

differential diagnosis