Rare bile duct cancer case treated at MRNH without jaundice

Malla Reddy Narayana Multispeciality Hospital (MRNH) on Friday successfully treated an extremely rare and complex case of gallbladder cancer in a 54-year-old male, where cancer-related tumor emboli were present in the bile duct without the usual symptom of jaundice — a presentation rarely reported in medical literature. The highly intricate surgery was performed by Dr. M. Manisegaran, Director – Minimal Access, HPB&GI Onco Surgeries at MRNH.

An unusual Case with mild symptoms

The patient, a known diabetic and hypothyroid, approached MRNH with only mild abdominal discomfort. Further investigations revealed a rare and complex combination of conditions: A large gallbladder tumour, multiple tumour emboli inside the Common Bile Duct (CBD), a type IV-A choledochal cyst (bile duct abnormality), associated liver cirrhosis. 

In this patient, the bile duct contained multiple cancer deposits. Normal bile flow was maintained. No clinical or laboratory signs of jaundice were present. This unusual presentation posed both a diagnostic and surgical challenge. The patient responded well to the surgery and is currently recovering under the combined care of HPB Surgery, Gastroenterology, and Critical Care teams. 

His post-operative condition remains stable, and further treatment will continue as per standard cancer care protocols.Dr. M. Manisegaran said that  Gallbladder cancer with tumour emboli in the bile duct is rare by itself and managing such a case without jaundice, along with choledochal cyst and cirrhosis, made it exceptionally unique. 

Chairman’s statement

Dr. Bhadra Reddy, Chairman, Malla Reddy Narayana Hospital further remarked that this achievement highlights MRNH’s ability to manage highly complex hepatobiliary and cancer cases. Dr. Preethi Reddy, Vice Chairperson, Malla Reddy Narayana Hospital said that cases like this reflect the hospital’s  commitment to listening beyond symptoms and diagnosing beyond the obvious.