Primary sclerosing cholangitis (PSC) is a rare, chronic, and progressive disease of the liver characterized by
cholestasis due to multifocal bile duct
strictures. PSC can lead to
liver fibrosis, and in 10-20% of cases, it leads to
cholangiocarcinoma and
end-stage liver disease. However, the pathogenesis of the disease is not clearly understood. For the diagnosis of PSC, both imaging and liver biopsy can be used. No medical treatment has managed to prevent the progression of the disease. Consequently, in the case of late-stage
disease, liver transplantation is considered the best treatment option. PSC may lead to different complications including bacterial
cholangitis,
cholangiocarcinoma, and
cirrhosis. Nevertheless, to our knowledge, there are no reports of granulomatous
peritonitis secondary to PSC. Granulomatous
peritonitis may be a result of infectious, malignant, and idiopathic inflammatory diseases. It is also considered a rare postoperative complication, due to
cornstarch from
surgical glove powder, in laparoscopic procedures. Here, we report the case of a 39-year-old male patient with PSC, in which
cholangiocarcinoma and
peritoneal carcinomatosis were clinically suspected. Despite that, histological findings and staining methods of the surgically removed peritoneal masses demonstrated granulomatous
peritonitis.