Brucellosis. A Rare Cause of Biliary Dysplasia and Ampullary Adenocarcinoma?

Brucellosis, a zoonotic bacterial infection often characterized by nonspecific symptoms including fever, night sweats, and weight loss, has a prolonged and recurrent course, often leading to chronic symptoms if inadequately treated. Hepatic involvement is well-documented with manifestations ranging from mild hepatitis to hepatic abscesses and granulomas. However, the association of brucellosis with biliary dysplasia or ampullary adenocarcinoma has not been previously reported in medical literature. We present a 68-year-old man with hepatic granulomatosis due to chronic brucellosis complicated by numerous episodes of ascending cholangitis secondary to choledocholithiasis and common bile duct strictures, with high-grade dysplasia and development of ampullary adenocarcinoma.