Clinical Report: Case Report of a Nonagenarian with Distal Biliary Tract Carcinoma

Background

Distal cholangiocarcinoma (dCCA) is a rare but aggressive malignancy with a poor prognosis, particularly in elderly patients who are often excluded from surgical options due to high perioperative risks. The occurrence of tumor-related granulomatous reactions adds complexity to the clinical management of such cases.

Data Highlights

No numerical data or trial data provided in the article.

Key Findings

• A 90-year-old female patient presented with upper abdominal pain and distension.
• Imaging studies indicated a mass in the head of the pancreas, leading to a pancreaticoduodenectomy.
• Pathology confirmed poorly differentiated cholangiocarcinoma with negative margins (R0 resection).
• No metastasis was found in regional lymph nodes, but non-caseating granulomas were observed.
• The patient experienced transient cardiac function stress and secondary fungal infection postoperatively, which were managed effectively.

Clinical Implications

Clinicians should consider the possibility of tumor-related granulomatous reactions in their differential diagnosis and follow-up protocols.

Conclusion

This case underscores the importance of thorough preoperative assessment in elderly patients and suggests that surgical intervention can be safely performed in select cases of distal cholangiocarcinoma.

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