![]() ![]() Therefore, although pathological confirmation was not obtained, the diagnosis of unresectable GBC was made based on the markedly elevated tumor markers and obvious imaging findings. Positron emission tomography showed the accumulation of fluorodeoxyglucose in the tumor and lymph nodes, including the para-aortic lymph nodes (Fig. The para-aortic lymph nodes were also swollen (Fig. 1a-1) and bulky lymph node metastases on the posterior surface of the pancreatic head infiltrating the common bile duct (Fig. ![]() Multidetector-row computed tomography (MDCT) revealed the tumor at the fundus of the gallbladder infiltrating the liver parenchyma (Fig. Laboratory data on admission showed elevated levels of serum total bilirubin at 15.5 mg/dL, γ-glutamyltranspeptidase at 1347 IU/L, carcinoembryonic antigen at 14.1 ng/mL, and carbohydrate antigen 19-9 at 609 U/mL. A 67-year-old woman with obstructive jaundice was referred to our hospital.
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