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Outline
Distal cholangiocarcinoma （dCCA） often has subtle symptoms in its early stage，and the optimal surgical timing is often missed at the time of diagnosis. This article reports a patient with dCCA who attended the hospital due to obstructive jaundice. Although the patient had a history of liver fluke infection and positive serological results，persistent stricture of the common bile duct remained unrelieved after adequate drainage and infection control. Due to the longitudinal growth pattern of the tumor，multiple endoscopic biopsies yielded false-negative results. Multidisciplinary consultation recommended a 1-month follow-up，but the patient failed to return to hospital for review and was found to have liver metastasis （stage Ⅳ） at the time of confirmed diagnosis，and thus the patient missed the opportunity for radical surgery. This article summarizes the common pitfalls and lessons in the early diagnosis of dCCA and proposes that for highly suspected cases in clinical practice，it is crucial to conduct multidisciplinary diagnosis and treatment，integrate dynamic imaging and tumor marker monitoring，and implement proactive structured evaluations，so as to avoid diagnostic and therapeutic delays and ultimately improve the prognosis of patients.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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