title: Repeated obstructive jaundice and acute pancreatitis caused by metastatic liver tumor: an unusual case.
abstract: A case of repeated obstructive jaundice and acute pancreatitis caused by mucus plug produced by metastatic liver tumor is reported. A 74-year-old woman, who had a past history of curative resection of mucinous rectal cancer, showed repeated obstructive jaundice and acute pancreatitis during the follow-up period. Neither computed tomographic scan nor abdominal ultrasound could detect the recurrent lesion, however, cholangioscopy detected mucin and tumor projection into the left hepatic duct. Since the biopsy specimen of the tumor revealed adenocarcinoma, left hepatectomy was performed. The tumor was mucinous adenocarcinoma having the same histology as the primary rectal cancer, with partly mucosal replacement and formation of intraluminal mucus plaque. This case indicates that repeated obstructive jaundice and acute pancreatitis should be considered one of the manifestations of liver metastasis of mucinous cancer.
authors.affiliation: Department of Surgery, Showa General Hospital, Tokyo, Japan. ta-koba@mb.kcom.ne.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
authors.forename: Keiji
authors.initials: K
authors.lastname: Sano
authors.forename: Kaname
authors.initials: K
authors.lastname: Koyama
authors.forename: Toru
authors.initials: T
authors.lastname: Motoi
mesh_terms: D000208:Acute Disease; D002288:Adenocarcinoma, Mucinous / Q000150:complications* / Q000556:secondary; D000368:Aged; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology*; D008113:Liver Neoplasms / Q000150:complications* / Q000556:secondary; D010195:Pancreatitis / Q000209:etiology*; D012004:Rectal Neoplasms / Q000473:pathology; D012008:Recurrence