Stenosis of the common bile duct due to Ormond's disease: case report and review of the literature

In a 46-year-old man endoscopic retrograde cholangiopancreatography and com puted tomography scan showed a stenosis of the common bile duct by a hypode nse mass highly suggestive of a Klatskin tumor. Histologic examination of t he resected tumor revealed only non-specific inflammatory, fibrotic tissue without any evidence of malignancy. Three months later, the patient present ed with hydronephrosis of the left kidney. Computed tomography scan showed a retroperitoneal mass with encasement of the left meter A percutaneous nep hrostomy was performed and immunosuppressive therapy with prednisolone and azathioprine was initiated, Under this medication, almost complete regressi on of the pelvic mass and reopening of the ureter were observed within 3 we eks. Eight months later, azathioprine was withdrawn and prednisolone was ta pered continuously to a dose less than 10 mg/day. After a follow-up of 2 ye ars, the patient is still well. Although the histologic findings were nonsp ecific, further evaluation of this case suggests that Ormond's disease was responsible for the tumor that had to be resected.