{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T10:43:26Z","timestamp":1780742606751,"version":"3.54.1"},"reference-count":13,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,9]],"date-time":"2023-07-09T00:00:00Z","timestamp":1688860800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Biliary cast syndrome, which was first reported in 1975, is a rare disease that occurs after liver transplantation. The incidence is even lower in patients who have not undergone liver transplantation. This study reports a rare case of biliary cast syndrome with cholangiocarcinoma-like lesions in a patient who did not undergo liver transplantation. Case Report: Herein, we report a case of a 69-year-old man with right upper quadrant pain and elevated levels of alkaline phosphatase and gamma-glutamyl transferase, who had a history of total gastrectomy for gastric cancer and laparoscopic cholecystectomy for acute cholecystitis. Computed tomography (CT) revealed longitudinal bile stones in the extrahepatic and intrahepatic bile ducts and abrupt narrowing of the left main bile duct accompanied by a narrowing of the upstream bile duct in the left lobe of the liver. Based on the CT findings, the removal of the bile stones in the bile duct and additional examinations of the suspected cholangiocarcinoma were performed. The patient\u2019s symptoms improved, and examinations for suspected cholangiocarcinoma showed no abnormal findings, and he was discharged one month later. Conclusions: The purpose of this case report is to share a rare case of Biliary Cast Syndrome (BCS) occurring without liver transplantation. Additionally, the report aims to share image findings that mimic cancer in BCS, with the goal of reducing unnecessary repetitive biopsies, minimizing patient discomfort, and decreasing unnecessary costs by aiding in the diagnosis of BCS.<\/jats:p>","DOI":"10.3390\/medicina59071272","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:35:21Z","timestamp":1688949321000},"page":"1272","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Case of Biliary Cast Syndrome with Cholangiocarcinoma-like Lesion in a Patient with No History of Liver Transplantation"],"prefix":"10.3390","volume":"59","author":[{"given":"Sa-Hong","family":"Jo","sequence":"first","affiliation":[{"name":"Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon 51472, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7616-5213","authenticated-orcid":false,"given":"Ho-Cheol","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju 52727, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2832-8900","authenticated-orcid":false,"given":"Sung-Eun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon 51472, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Il","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon 51472, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4824-1933","authenticated-orcid":false,"given":"Jung-Ho","family":"Won","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju 52727, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Boem","family":"Na","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju 52727, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang-Won","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju 52727, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won-Jeong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju 52727, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byeong-Ju","family":"Koo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju 52727, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Kyeong","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju 52727, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong-Je","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju 52727, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"382","DOI":"10.4166\/kjg.2012.60.6.382","article-title":"Biliary cast syndrome in non-liver surgery patients","volume":"60","author":"Ha","year":"2012","journal-title":"Korean J. Gastroenterol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1097\/00007890-197505000-00004","article-title":"Bile composition and bile cast formation after transplantation of the liver in man","volume":"19","author":"Waldram","year":"1975","journal-title":"Transplantation"},{"key":"ref_3","first-page":"419","article-title":"A Case of Biliary Cast Syndrome in a Non-liver Transplant Patient","volume":"42","author":"Jun","year":"2011","journal-title":"Korean J. Gastrointest. Endosc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"224","DOI":"10.3348\/jksr.2021.0013","article-title":"A Case of Biliary Cast Syndrome after Endoscopic and Percutaneous Management of Common Bile Duct Stone","volume":"83","author":"Chun","year":"2022","journal-title":"J. Korean Soc. Radiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.1002\/lt.21492","article-title":"Biliary cast syndrome following liver transplantation: Predictive factors and clinical outcomes","volume":"14","author":"Gor","year":"2008","journal-title":"Liver Transpl."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"98","DOI":"10.5946\/ce.2013.46.1.98","article-title":"A case of biliary cast developed in a patient with long-standing biliary sludge","volume":"46","author":"Koo","year":"2013","journal-title":"Clin. Endosc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1097\/00042737-200304000-00001","article-title":"Cholangiopathy and the biliary cast syndrome","volume":"15","author":"Parry","year":"2003","journal-title":"Eur. J. Gastroenterol. 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