Obstructive jaundice caused by intraductal metastasis of lung adenocarcinoma.

[cholangiocarcinoma]

Obstructive jaundice caused by metastases to the porta hepatis is often observed in patients with various advanced cancers ; however , metastasis of lung cancer to the common bile duct with subsequent development of jaundice is rare . A 75 -year -old female with lung adenocarcinoma harboring epidermal growth factor receptor (EGFR ) mutation (15 -bp in -frame deletion in exon 19 and T 790 M in exon 20 ) developed obstructive jaundice during therapy . Obstruction of the common bile duct caused by an intraductal tumor was identified by computed tomography , endoscopic retrograde cholangiopancreatography , and endoscopic ultrasonography . Although primary cholangiocarcinoma was highly suspected according to the imaging findings , immunohistochemical evaluation of the intraductal tumor demonstrated thyroid transcription factor -1 positive adenocarcinoma . Furthermore , peptide nucleic acid-locked nucleic acid polymerase chain reaction clamp analysis showed that the tumor contained the same EGFR mutation as that in the primary lung cancer . Thus , we confirmed intraductal metastasis from a lung adenocarcinoma . To our knowledge , this is the second report of obstructive jaundice caused by intraductal metastasis of lung cancer .