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Figure 19d.   Rhabdomyosarcoma of the common bile duct in a 7-year-old boy with jaundice, hepatomegaly, and itching. (a) Transverse scan of the pancreas (P) shows a round, solid heterogeneous mass (arrows) in the region of the pancreatic head. (b) Oblique sonogram of the porta hepatis shows the solid mass (arrows) in the markedly dilated common bile duct (CBD). GB = gallbladder, PV = portal vein. (c) Transverse sonogram of the liver demonstrates dilated intrahepatic ducts (arrow), coarse liver texture thought to be due to cholestasis, and a normal gallbladder (GB). (d) Intraoperative cholangiogram helps confirm the presence of the large mass with irregular borders filling the distal common bile duct (arrows).