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Thursday, December 18, 2014
Is it cancer?
Can you give me any suggestions? thank you!!!!! Male, 79 years old, non drinker, non smoker. Had MRI for hematuria, which turned out to be idiopathic. The MRI showed that the common bile duct was blocked, and a blood test showed elevated liver enzymes.
ERCP showed a stricture in the CBD with a smooth appearance, biliary brushings were mildly atypical. A plastic stent was inserted, and a subsequesnt EUS showed that the pancreas had an irregular, non smooth appearance, but no mass.
CAT scan showed no mass, CA19 level is 98. I Had a laparoscopic cholecystectomy nine years ago, and have had no symptoms of any kind. Liver enzymes were normal after the stent placement. Thank you in advance for your suggestions. My doctors won`t commit to any specific diagnosis
This question has been forwarded by Colorectal Diseases:
It sounds like there is no specific diagnosis available at this time based on the testing you have already done. Obviously your doctors are concerned about a possible cancer of the pancreas or bile ducts and therefore did the tests you mentioned to try to make a diagnosis. They will likely want to repeat some of the tests you've had done again (for ex. the CA19-9 level) to see if there is a change in the values. Also, since you have a plastic stent in place, it will need to be changed or removed in the near future. At that time, your doctors will likely look at the CBD again and if it's still narrow, possibly do more brushings at that time. Good luck.
Julia Gore Thornton, MD
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University