case_images: PMC10327893_01
case_images: (A) Enhanced CT showed the dilation of intrahepatic bile duct. (B) MRCP showed the common bile duct stricture in the head of the pancreas (white arrow), additional soft tissue shadows were not seen at the surrounding regions and the upstream common bile duct and intrahepatic bile duct dilated significantly. (C) ERCP indicated that biliary stricture was at the upper common bile duct and hilar bile duct (black arrows) and left intrahepatic bile duct dilated significantly. (D) SpyGlass showed that an oval space-occupying lesion was seen at the upper segment of the common bile duct (black arrow). The biliary wall (white arrow) was smooth. The lesion filled the bile duct lumen, resulting in bile duct obstruction. The surface of this lesion was smooth, without dilated and tortuous blood vessels. (E) Postoperative pathological examination revealed secretory biliary cystadenoma.
case_images: fmed-10-1175034-g0001.jpg
case_images: PMC10327893_01_fmed-10-1175034-g0001.jpg
case_images: F1
case_images: Moreover, the computed tomography (CT) (Figure 1A) and magnetic resonance cholangiopancreatography (MRCP) (Figure 1B) demonstrated that the common bile duct stenosis located at the head of the pancreas and the upstream bile duct dilatation was significant. The biliary cholangiography revealed an indeterminate stenosis at the upper bile duct (Figure 1C). The surface mucosa of the lesion was smooth, without neovascularization (Figure 1D and Supplementary Video S1). Immunohistochemistry results showed a CD10 (+), ER (+), PR weak (-), and Ki67: 5% (+) secretory cystadenoma (Figure 1E).