A super-elderly patient with distal biliary tract cancer and tumor-associated granuloma: a case report
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By
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Longfei Chen
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Rong Ran
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Jing Wu
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Futang Li
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Zikai Wei
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Zhiwei He
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Chao Yu
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July 3, 2026
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Clinical Scorecard: Case Report of a Nonagenarian with Distal Biliary Tract Carcinoma and Associated Granuloma
At a Glance
| Category | Detail |
|---|
| Condition | Distal Cholangiocarcinoma (dCCA) |
| Key Mechanisms | Poorly differentiated cholangiocarcinoma with tumor-related granulomatous reactions. |
| Target Population | Elderly patients (≥80 years old) with dCCA. |
| Care Setting | Multidisciplinary surgical management in a hospital setting. |
Key Highlights
- 90-year-old female patient with upper abdominal pain and distension.
- Underwent pancreaticoduodenectomy with R0 resection.
- No cancer metastasis found in regional lymph nodes.
- Postoperative complications included transient cardiac function stress and fungal infection.
- Age should not be an absolute contraindication for surgery in elderly dCCA patients.
Guideline-Based Recommendations
Diagnosis
- Imaging studies to assess the presence of masses in the biliary tract.
Management
- Radical surgery as the only potential curative approach for dCCA.
Monitoring & Follow-up
- Vigilance for tumor-related granulomatous reactions during follow-up.
Risks
- High perioperative risks in elderly patients.
Patient & Prescribing Data
Elderly patients with dCCA.
Meticulous volume management and supportive treatment post-surgery.
Clinical Best Practices
- Conduct a detailed preoperative multidisciplinary assessment for elderly patients.
- Consider patient and family preferences in treatment planning.
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