Obstructive jaundice caused by metastasis of lung cancer to distal common bile duct (CBD) is extremely rare. Here, we report a 70-year-old man presented with progressive jaundice and generalized weakness for 1 month. He had a medical history of stage IIB (pT2N1M0) lung adenocarcinoma, for which he had undergone surgical treatment and subsequent adjuvant chemotherapy 3 years ago. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a distal CBD stricture. Histopathological examination of the biopsy specimen taken from the stricture site demonstrated adenocarcinoma with positive for cytokeratin-7 and thyroid transcription factor-1 on immunohistochemistry. The findings confirmed the diagnosis of metastasis of recurrent lung adenocarcinoma to the CBD. The patient's jaundice improved after insertion of an endoscopic retrograde bile duct (ERBD) drainage plastic stent at the time of ERCP. He was then started on target therapy with afatinib after discharge. The ERBD stent was removed 3 months later. He had remained in stable condition without jaundice during the 1-year follow-up period. In conclusion, obstructive jaundice caused by metastatic adenocarcinoma to the CBD is a rare manifestation of lung cancer. An accurate diagnosis is crucial in further treatment for such a patient.
