Carcinoma in situ arising in a tubulovillous adenoma of the distal common bile duct: A case report

Abstract

Kim BS, Joo SH, Joo KR. Carcinoma in situ arising in a tubulovillous adenoma of the distal common bile duct: A case report.

A rare cause of dilated bile duct incidentally detected on imaging

“…Patients with extrabiliary adenomas, on the other hand, have symptoms similar to cholangiocarcinoma with obstruction of biliary trees causing jaundice, fever, abdominal pain, biliary colic and pruritus 2. Our patient, however, was asymptomatic and the adenoma was detected incidentally.…”

“…Meanwhile, adenomas of the extrahepatic biliary tree are incredibly sparse and intestinal histology is the commonest 5. Morphologically they are divided into papilloma, tubular adenoma, villous adenoma or tubulovillous adenoma 2 7. Rarely there can be fibromas and neuromas 1.…”

“…Adenomas involving the extrahepatic bile ducts are rare benign tumours of the biliary tract 1 2. Given the asymptomatic nature of these tumours and the natural progression of biliary adenoma to carcinoma including cholangiocarcinoma, early detection is challenging.…”

Tubulopapillary adenoma of the common bile duct presenting with jaundice

“…These have the same morphologic characteristics as intestinal villous/tubulovillous adenomas, and have a high risk of malignancy (6, 7). The first papillary (villous) adenoma of the common bile duct in the English literature has been reported by Saxe et al (9) and a total of 27 cases have been reported so far (3,8).…”

“…General symptoms are bile duct obstruction and jaundice. They may be confused with common bile duct stones and malignant tumors during pre-operative evaluation (3,4). Thus, unnecessary extensive surgical procedures can be applied in some cases.…”