Case History
The patient was a 66-year-old woman who had been receiving chemotherapy
comprising pertuzumab, trastuzumab, and docetaxel for invasive ductal
breast cancer with liver and brain metastases, since 2016. She became
aware of epigastric discomfort in October 2019; in early December of the
same year, she began passing dark-colored urine and visited our
hospital. Blood tests revealed elevated hepatobiliary enzymes, while
contrast-enhanced computed tomography (CECT) scan of the abdomen showed
wall thickening of the middle to distal bile duct and dilated
intrahepatic bile ducts. No mass was evident around the bile duct wall
(Fig. 1). Obstructive jaundice due to malignant lesion in the bile duct
was suspected and the patient was admitted to our hospital for further
investigation and treatment.