Rare common bile duct metastasis of breast cancer: A case report and literature review

Figure 1 Magnetic resonance cholangiopancreatography. Findings of dilatation of the common bile duct, stenosis of the distal common bile duct, and density shadow of soft tissue are indicated by an arrow.

Figure 2 Endoscopy findings. Ultrasound gastroscopy revealed widening of the bile duct wall (arrows).

Figure 3 Magnetic resonance imaging of the abdomen. A and B: The wall of the common bile duct was thickened (arrows) and became obviously enhanced with contrast agent; C: Local nodular thickening was seen in the lower segment of the common bile duct (arrow).

Figure 4 Endoscopy findings. A: Endoscopic retrograde cholangiopancreatography showed dilatation of the common bile duct and stenosis of the distal common bile duct (arrow); B: Edema of the ampulla; C: Implanted plastic stent.

Figure 5 Bone scan findings. A: Metastasized tumors in the left third rib; B: Metastasized tumors in the eighth vertebral body.

Figure 6 Histopathology of biopsies of the common bile duct and the skin of left neck and chest. A: Cancer cells were found to have infiltrated the glandular duct of the common bile duct (CBD); B and C: Low-power magnifications (B: 2´, C: 40´) demonstrating cancer embolus in the vasculature of the skin; D: Positive immunohistochemistry (IHC) staining for CD34 in the cancer embolus areas; E and F: Strong positive IHC staining for cytokeratin (CK) 7 and trans-acting T-cell-specific transcription factor (GATA-3) in the CBD; G: Strong positive IHC staining for CK7 in the skin of left neck and chest; H: Strong positive IHC staining for GATA3 in the skin of left neck and chest.