To report a rare case of a 90-year-old female patient with distal cholangiocarcinoma (dCCA) who underwent surgical management.
Approach:
Patient Presentation: A 90-year-old woman presented with upper abdominal pain and distension. Imaging suggested a mass in the head of the pancreas.
Surgical Intervention: After a thorough preoperative assessment, the patient underwent pancreaticoduodenectomy, which confirmed poorly differentiated cholangiocarcinoma with negative margins.
Postoperative Management: Post-surgery, the patient received volume management and supportive treatment, experiencing transient cardiac stress and a fungal infection, both of which were managed.
Key Findings:
The patient had poorly differentiated cholangiocarcinoma with negative margins and no lymph node metastasis.
Non-caseating granulomas were observed, interpreted as tumor-related granulomatous reactions.
Interpretation:
The case highlights the potential for successful surgical intervention in elderly patients with dCCA, emphasizing the need for careful preoperative evaluation.
Limitations:
Limited evidence on the management of elderly patients with dCCA due to underrepresentation in clinical trials.
The rarity of tumor-associated granulomatous reactions complicates understanding and management.
Conclusion:
This case suggests that with appropriate evaluation and management, radical surgery can be safely performed in elderly patients with dCCA.
