Biliary hemorrhage caused by a malignant small round cell tumor in the common bile duct: A case report

Figure 1 Endoscopic retrograde cholangiopancreatography examination and treatment. A: Duodenal papilla hemorrhage revealed by endoscopic retrograde cholangiopancreatography; B: Placement of a biliary covered metal stent.

Figure 2 A neoplasm of the common bile duct with active bleeding was observed under a SpyGlass.

Figure 3 Malignant small round cell tumor with tumor cells showing some cytoplasm and difficult-to-see karyokinesis was observed under a light microscope following hematoxylin and eosin staining of the tumor tissue.

Figure 4 The SS18 gene break test by fluorescence in situ hybridization revealed mostly red and green markers in a fusion state and only a few red and green markers in a nonfusion state (fluorescence in situ hybridization-positive cells), indicating that the SS18 gene break test result was negative.