Patient case: Gall Ductal Cancer
A 65-year-old female presents to the clinic with complaints of jaundice, dark urine, and pale stools for the past three weeks. She reports progressive fatigue and unintentional weight loss of 6 kg over the past two months. Additionally, she has experienced intermittent abdominal pain in the upper right quadrant, radiating to her back, along with itching of the skin.
On physical examination, the patient is visibly jaundiced. There is mild tenderness in the right upper quadrant of the abdomen, but no palpable masses. Laboratory tests reveal elevated liver enzymes, particularly alkaline phosphatase and bilirubin levels. An abdominal ultrasound shows dilation of the bile ducts, prompting further imaging with an MRI and MRCP (magnetic resonance cholangiopancreatography), which identifies a mass in the common bile duct. A biopsy is performed, confirming the diagnosis of cholangiocarcinoma (gall ductal cancer).
The patient is referred to an oncology team and is discussed for possible surgical resection. Given the locally advanced nature of the tumor, neoadjuvant chemotherapy is recommended before surgery. The patient is counseled on the treatment plan, including potential outcomes and the importance of regular follow-ups, and chemotherapy is initiated.
a). Severe vomiting and diarrhea
b). Jaundice, dark urine, pale stools, and upper right abdominal pain
c). Chest pain and shortness of breath
d). Coughing and blood in the sputum
a). Abdominal X-ray
b). CT scan of the abdomen
c). MRI with MRCP
d). Endoscopy
a). Pancreatic adenocarcinoma
b). Hepatocellular carcinoma
c). Cholangiocarcinoma (gall ductal cancer)
d). Colorectal cancer
a). Palliative care only
b). Immediate surgical resection
c). Neoadjuvant chemotherapy followed by surgical resection
d). Radiation therapy
