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Tumor Discovery

CASE REPORT
An unusual case of malignant biliary tract

obstruction

1
Sakditad Saowapa * , Chalothorn Wannaphut 2 , Hector Jose Garcia Pleitez 1 ,
Andrea Ortiz Maldonado , Miriam Alicia Paz Sierra 1 , Natchaya Polpichai 3 ,
1
4
5
Pharit Siladech , Meenu Sharma , and Lukman Tijani 6
1 Department of Internal Medicine, Texas Tech University Health Sciences Center at Lubbock,
Lubbock, Texas, United States of America
2 Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii,
United States of America
3 Department of Internal Medicine, Louis A. Weiss Memorial Hospital, Chicago, Illinois,
United States of America
4 Department of Internal Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University,
Bangkok, Thailand
5 Department of Pathology, Texas Tech University Health Sciences Center at Lubbock, Lubbock,
Texas, United States of America
6 Department of Hematology and Oncology, Texas Tech University Health Sciences Center at
Lubbock, Lubbock, Texas, United States of America

Abstract
*Corresponding author:
Sakditad Saowapa Malignant biliary tract obstruction (MBTO) is most commonly associated with primary
(sakditad.saowapa@ttuhsc.edu) hepatobiliary and pancreatic malignancies. Here, we present a rare case of a 65-year-
Citation: Saowapa S, old female who developed obstructive jaundice, which initially raised suspicion for
Wannaphut C, Pleitez HJC, et al. hepatobiliary carcinoma. Cross-sectional imaging, including computed tomography
An unusual case of malignant biliary and magnetic resonance imaging, revealed hepatic lesions, and endoscopic
tract obstruction. Tumor Discov.
2025;4(3):96-99. retrograde cholangiopancreatography demonstrated a malignant biliary stricture.
doi: 10.36922/TD025070011 Histopathological analysis of a liver biopsy unexpectedly confirmed metastatic
Received: February 11, 2025 urothelial carcinoma (UC). Further evaluation with cystoscopy, prompted despite the
absence of urinary symptoms, identified a small bladder mass, which was biopsy-
1st revised: April 18, 2025 proven as the primary UC. UC typically metastasizes to lymph nodes, lungs, or bones,
2nd revised: May 4, 2025 and isolated liver involvement causing MBTO is exceptionally uncommon. This case
3rd revised: May 27, 2025 underscores the importance of maintaining a broad differential diagnosis in patients
with malignant biliary obstruction, as atypical metastatic patterns can mimic more
Accepted: June 5, 2025 common hepatobiliary cancers and delay appropriate management.
Published online: June 25, 2025
Copyright: © 2025 Author(s). Keywords: Malignant biliary tract obstruction; Cholangiocarcinoma; Urothelial
This is an Open-Access article
distributed under the terms of the carcinoma; Hepato-pancreato-biliary cancer; Bladder cancer
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium,
provided the original work is
properly cited. 1. Background
Publisher’s Note: AccScience Malignant biliary tract obstruction (MBTO) is a common condition that could arise
Publishing remains neutral with from hepato-pancreato-biliary cancer or metastasis from other primary cancers such
regard to jurisdictional claims in
published maps and institutional as pancreatic adenocarcinoma or cholangiocarcinoma. The common metastatic cancers
affiliations. causing MBTO by extrinsic compression include colon, stomach, breast, lung, and

Volume 4 Issue 3 (2025) 96 doi: 10.36922/TD025070011