case_images: PMC10559499_01
case_images: A 29-year-old woman with small-cell cancer of the perihilar bile duct who presented bleeding esophageal varices. (a) Upper gastrointestinal endoscopy showed the esophageal varices (white arrow), (b) gastric retroflexion experienced the blood in fundus, (c) esophageal endoscopic imaging showed the position of bleeding esophageal varices (white arrow), and (d) endoscopic variceal ligation with one rubber band (white arrow) was done.
case_images: JCIS-13-30-g001.jpg
case_images: PMC10559499_01_JCIS-13-30-g001.jpg
case_images: F1
case_images: Endoscopic variceal ligation with one rubber band was performed successfully on the 1st day of the patient's admission [Figure 1].
case_images: A 29-year-old woman with small-cell cancer of the perihilar bile duct who presented bleeding esophageal varices. (a) Abdominal ultrasonography revealed a 9 x 12 cm sized heterogeneous mass located in the perihilar bile duct (white arrow), (b) multiple hyperechoic mass were experienced in ultrasound imaging of the liver (white arrow).
case_images: JCIS-13-30-g002.jpg
case_images: PMC10559499_01_JCIS-13-30-g002.jpg
case_images: F2
case_images: Abdominal ultrasound revealed multiple hyperechoic masses in the liver and a large heterogeneous mass in the perihilar bile duct [Figure 2].
case_images: A 29-year-old woman with small-cell cancer of the perihilar bile duct who presented bleeding esophageal varices, (a) abdominal computed tomography (CT) scan revealed the low-density perihilar bile duct mass (white arrow), (b) the tumor gradually improved the density in the arterial (white arrow), (c) the tumor invaded portal vein (white arrow), and caused liver collateral circulation to enlarge (black arrow), and (d) The tumor invaded the duodenum and pancreas (white arrow), (e and f) the chest CT was normal.
case_images: JCIS-13-30-g003.jpg
case_images: PMC10559499_01_JCIS-13-30-g003.jpg
case_images: F3
case_images: No lesion was found on chest CT [Figure 3].
case_images: A 29-year-old woman with small-cell cancer of the perihilar bile duct who presented bleeding esophageal varices. A low-density perihilar bile duct mass was detected on an abdominal computed tomography scan. The tumor underwent a percutaneous needle biopsy. Histologic findings of the liver biopsy in the described patient with small-cell cancer. (a and b) Images illustrate hematoxylin and eosin staining, x10 and x40, respectively, the tumor consists of round, oval small cells with minimal cytoplasm, fine chromatin, and no distinct nucleoli; necrosis is predominant. Immunohistochemistry for positive synaptophysin (c), Ki67: 85% (e); negative for chromogranin A (d) and CD 56 (f).
case_images: JCIS-13-30-g004.jpg
case_images: PMC10559499_01_JCIS-13-30-g004.jpg
case_images: F4
case_images: The tumor was then classified as small-cell cancer based on histological and immunohistochemical findings [Figure 4].