Solitary Synchronous Biliary Metastasis in Colorectal Adenocarcinoma
Bibliographic record
Abstract
Malignant biliary obstruction can, in rare cases, arise from metastases to the biliary tree from distant primary tumors. This phenomenon often poses a diagnostic challenge, as bile duct metastases may clinically and radiologically mimic primary biliary tumors, such as cholangiocarcinoma. We present a unique case of solitary, synchronous intraductal biliary metastasis in a patient with colorectal adenocarcinoma that led to biliary obstruction. The patient initially presented with a new diagnosis of colon cancer at the hepatic flexure and was found, on cross-sectional imaging, to have biliary obstruction due to an intraductal mass. Initially, the nature of the intraductal lesion was uncertain; however, it was ultimately confirmed through histopathological examination to be metastatic colorectal adenocarcinoma. This case underscores the difficulty of distinguishing metastatic biliary obstruction from primary biliary tumors and highlights the importance of considering metastatic disease in atypical presentations of biliary masses. We discuss several key radiologic and histopathological features that may help differentiate intraductal colorectal adenocarcinoma metastases from primary biliary tumors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".