Case presentation A woman in her late 60s presented with a 4-week history of jaundice, abdominal pain, and pruritus. She also reported nausea, decreased appetite, and a 6-kg weight loss.

There was no history of fever, abdominal distension, or bleeding tendencies. Medical history Colon cancer diagnosed 6 months earlier: mucinous adenocarcinoma, pT3N2bM0 Laparoscopic right hemicolectomy and ileotransverse anastomosis Six cycles of adjuvant chemotherapy with capecitabine and oxaliplatin Family medical history unremarkable, with no known cases of gastrointestinal malignancies Physical examinations Ill-nourished Icteric Left supraclavicular lymphadenopathy Enlarged gall bladder No respiratory, cardiovascular, and nervous systems abnormalities Blood investigations Anemia, cholestatic jaundice, and elevated carcinoembryonic antigen Hemoglobin – 87 g/L WBC – 8.4 x 109/L Platelet count – 235 x…