Neuroma of the bile duct mimicking cholangiocarcinoma

Elkhatib, Imad; Shah, Natasha; Savides, Thomas J.

doi:10.1016/j.gie.2016.06.011

Cited by 3 publications

(2 citation statements)

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“…Our patient had an elevated CA 19-9 levels of 2,252 U/ml (normal range <27) prior to surgery. CA 19-9 levels are often elevated with biliary tract carcinoma but also in benign diseases such as liver diseases, ascending cholangitis, and pancreatitis [41-43]. Other factors that were thought to help delineate malignant versus benign strictures of the biliary tree (total bilirubin >75 μmol, greater stricture length, and the presence of intrahepatic biliary dilation) were all suggestive but not diagnostic for malignant biliary stricture [44].…”

Section: Discussionmentioning

confidence: 99%

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Diffuse Neuromatosis of Intrahepatic and Extrahepatic Bile Ducts as a Rare Cause of Jaundice

et al. 2020

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Background: Neuroma of the biliary tree is extremely rare with no more than 100 cases reported so far. They mostly present with obstructive jaundice and have been commonly described after surgery or abdominal trauma. Although involvement of the extrahepatic bile duct is far more common, occurrence in the intrahepatic ducts has not so far been reported. Case Report: We describe 3 cases of diffuse biliary tree neuroma affecting 3 females aged 53–68 years. None had a history of neurofibromatosis type1. All presented with progressive obstructive jaundice with no evidence of gallstones. A history of previous surgery was noted in 2 patients. Initial impression on clinical and imaging examination was highly suspicious for bile duct carcinoma in 2 patients. Histology showed diffuse neuromatous proliferation replacing and thickening the bile duct walls. The third patient had concurrent neuroma and recurrent cholangiocarcinoma causing great clinical confusion as initial biopsy showed only benign neuroma, but CA 19-9 was steadily increasing, necessitating a second biopsy which then confirmed recurrent carcinoma. Conclusion: This uncommon cause of long-distance bile duct stenosis and progressive jaundice should be included in the differential diagnosis of bile duct neoplasms, in particular when there is a previous surgical history in this abdominal region.

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Section: Discussionmentioning

confidence: 99%

“…The differential diagnosis of obstructive jaundice includes postinflammatory fibrosis, retained stones, postoperative scar stricture, bile duct carcinoma or cystadenoma, adenocarcinoma of pancreas and extrinsic compression [9, 43, 45]. Benign tumors of the biliary tree leading to obstructive jaundice are rare [46, 47].…”

Section: Discussionmentioning

confidence: 99%

Diffuse Neuromatosis of Intrahepatic and Extrahepatic Bile Ducts as a Rare Cause of Jaundice

et al. 2020

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Recurrent Cholangitis Secondary to a Traumatic Biliary Neuroma

Rayyan

Aburumman

Altaweel

et al. 2022

Case Rep Gastroenterol

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Biliary amputation neuroma is rare and difficult to diagnose preoperatively due to diversity of clinical presentation and a lack of awareness among healthcare providers. We present a case of biliary neuroma arising from a recent laparoscopic cholecystectomy, complicated by bile leak and recurrent cholangitis. An extensive review of the literature was performed, closely examining related etiology, trends in age, clinical symptomology, and time to presentation. The role of surgery compared to an endoscopic approach in diagnosis has been reviewed. Physicians are urged to remain mindful of malignant biliary strictures as they may easily mimic and misguide the diagnosis of a traumatic biliary neuroma.

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Traumatic bile duct neuroma presenting with acute cholangitis: A case report and review of literature

Lalchandani

Korn

et al. 2019

Ann Hepatobiliary Pancreat Surg

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Traumatic neuroma of the biliary tree has been previously reported as isolated case reports. In literature, these typically present following prior liver transplant or cholecystectomy, wherein the bile ducts have been disrupted in some form. Here we report the case of a 41-year old male who initially presented with acute cholangitis ten years after an open cholecystectomy complicated by a bile leak. Endoscopic retrograde cholangiography revealed a stricture within the mid distal common hepatic duct. The patient temporarily resolved his initial episode with stent placement, and he was eventually taken to the operating room for bile duct resection and hepaticojejunostomy given a persistent stricture and concern for underlying malignancy. Final pathology demonstrated a traumatic bile duct neuroma. This unusual entity should be considered in patients with benign appearing strictures presenting years after surgery, and awareness may aid in preoperative counseling as well.

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Neuroma of the bile duct mimicking cholangiocarcinoma

Cited by 3 publications

References 0 publications

Diffuse Neuromatosis of Intrahepatic and Extrahepatic Bile Ducts as a Rare Cause of Jaundice

Diffuse Neuromatosis of Intrahepatic and Extrahepatic Bile Ducts as a Rare Cause of Jaundice

Recurrent Cholangitis Secondary to a Traumatic Biliary Neuroma

Traumatic bile duct neuroma presenting with acute cholangitis: A case report and review of literature

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