Morimoto Kosaku, Matsumoto Kazuyuki, Okuyama Takaki, Kimura Shogo, Takei Kensuke, Satomi Takuya, Okada Tsuyoshi, Shinoura Susumu, Shibata Rei, Takenaka Ryuta
Department of Internal Medicine, Tsuyama Chuo Hospital, Tsuyama, Japan.
Department of Gastroenterology and Hepatology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama City, 700-8558, Japan.
Clin J Gastroenterol. 2025 Sep 1. doi: 10.1007/s12328-025-02211-1.
We report a case of obstructive jaundice due to recurrent distal biliary stricture during 3 years of treatment for immunoglobulin G4 (IgG4)-related sclerosing cholangitis (IgG4-SC) associated with autoimmune pancreatitis. Although a relapse of IgG4-SC was initially suspected, imaging findings, laboratory tests, and histopathological examinations led to the diagnosis of metachronous cholangiocarcinoma. The patient underwent pancreaticoduodenectomy, and no cancer recurrence was noted 6 months postoperatively. Distal cholangiocarcinoma and IgG4-SC remission were observed in the resected specimen. In patients with recurrent biliary strictures during IgG4-SC treatment, comprehensive evaluations are essential because of the risk of disease relapse and development of metachronous cholangiocarcinoma.
我们报告了一例在免疫球蛋白G4（IgG4）相关硬化性胆管炎（IgG4-SC）合并自身免疫性胰腺炎的3年治疗期间，因复发性远端胆管狭窄导致梗阻性黄疸的病例。尽管最初怀疑是IgG4-SC复发，但影像学检查结果、实验室检查和组织病理学检查最终诊断为异时性胆管癌。该患者接受了胰十二指肠切除术，术后6个月未发现癌症复发。在切除的标本中观察到远端胆管癌和IgG4-SC缓解。对于在IgG4-SC治疗期间出现复发性胆管狭窄的患者，由于存在疾病复发和异时性胆管癌发生的风险，进行全面评估至关重要。
