[Cholestatic icterus and subsequent diagnostic steps].

We report about a seventy year old patient with painless jaundice, loss of weight and signs of laboratory-confirmed cholestasis. A CT-Scan revealed a tumor mass in the pancreatic head with extensive liver metastasis. We illustrate the required diagnostic steps to assess cholestasis and painless icterus. A definite diagnosis can not always be made even with extensive histological or immunohistochemical workup.