CASE REPORT: Extrahepatic Biliary Schwannoma

Honjo, Yumiko; Kobayashi, Yoshimasa; Nakamura, Toshifumi; Takehira, Yasunori; Kitagawa, Mutsuo; Ikematsu, Yoshito; Ozawa, Tomohiro; Nakamura, Hirotoshi

doi:10.1023/b:ddas.0000004531.97727.66

Cited by 23 publications

(19 citation statements)

References 8 publications

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“…Peripheral nerve sheath tumors represent 2-6% of GIST [4]. Schwannomas of the biliary tract are extremely rare and occur because of an abundant network of sympathetic and parasympathetic nerve fibers to the wall of the gallbladder and bile duct [3,5]. Since 1955, only 11 cases of schwannoma of CBD have been reported, this being the twelfth one [6].…”

Section: Discussionmentioning

confidence: 99%

Schwannoma of common bile duct causing obstructive jaundice

et al. 2010

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Benign schwannomas arise from neural crest-derived Schwann cells. Schwannomas occurring in the biliary tract become clinically symptomatic due to their compression on the extra hepatic biliary tract causing obstructive jaundice. Their preoperative diagnosis is extremely difficult. We report a 38-year-old male who presented with pain abdomen and jaundice.Computed tomography of abdomen showed extra luminal compression of common bile duct (CBD) possibly by a lymph nodal mass. Resection of the CBD, gall bladder and the mass compressing the CBD with Rouxen-Y hepaticojejunostomy was performed. The final histopathology was reported as a schwannoma.

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Section: Discussionmentioning

confidence: 99%

Schwannoma of common bile duct causing obstructive jaundice

et al. 2010

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“…3,5 They usually arise in the soft tissues of the head, neck, spinal cord, mediastinum, and extremities because they occur along the course of a peripheral, cranial, or sympathetic nerve. 5 In the digestive system, they may arise in the gastrointestinal tract and the liver. 5 As they represent only 6% of primary retroperitoneal tumors, rare cases in the common bile duct have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…5 In the digestive system, they may arise in the gastrointestinal tract and the liver. 5 As they represent only 6% of primary retroperitoneal tumors, rare cases in the common bile duct have been reported. [5][6][7] They can develop occasionally in the setting of type 2 neurofibromatosis.…”

Section: Discussionmentioning

confidence: 99%

“…5 As they represent only 6% of primary retroperitoneal tumors, rare cases in the common bile duct have been reported. [5][6][7] They can develop occasionally in the setting of type 2 neurofibromatosis. 7,8 In our case report no familial or personal history of neurofibromatosis was found.…”

Section: Discussionmentioning

confidence: 99%

“…These are much more rare 12,13 and may be the result of chronic inflammatory lesions, infections, granulomatous reactions to foreign bodies, or ischemic lesions. 12 They can be associated with biliary stones, 5 as it seems that bile stasis owing to mechanical obstruction of the bile duct by the neurinoma can encourage lithogenesis.…”

Section: Discussionmentioning

confidence: 99%

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Primary neurofibroma of the common bile duct: a case report

Béchade

Boulanger

Palazzo³

et al. 2009

Gastroenterol Insights

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Obstructive jaundice secondary to common bile duct stricture is attributed most commonly to pancreatic cancer and cholangiocarcinoma. Benign tumors of the extrahepatic biliary duct such as papilloma or adenoma are rare, accounting for 6% of biliary tumors.1,2 Among them, neurofibromas of the extrahepatic biliary tract are extremely rare and clinically nonspecific. Their preoperative diagnosis is most difficult, especially when there is no history of cholecystectomy or biliary tract trauma.3,4 We report a case of such a lesion in a young female patient. Case ReportA 28-year-old female patient was referred for upper abdominal pain and fever (38.5°C) that had been evolving over eight days. She had no family history of a hereditary disorder, nor personal previous history of cholecystectomy or trauma of the bile duct. The physical examination was normal, except for tenderness in the right hypochondrium. There was no evidence of jaundice. The laboratory studies revealed: serum alanine aminotransferase (ALAT), 54Abdominal ultrasonography showed mild hepatomegaly and slight dilatation of the intrahepatic biliary tracts, which seemed to be secondary to adenopathies of the hepatic hilum measuring 15.8 mm and 12.9 mm. Abdominal computed axial tomography (CT) (Figure 1) showed a well-demarcated, homogeneous and hypodense mass (20-35 UH) on unenhanced scans, with no enhancement after injection of the contrast medium. The mass surrounded the entire common bile duct and invaded the hepatic hilum, without any dilatation of the intrahepatic biliary tracts and without adenopathy. Abdominal magnetic resonance imaging (MRI) (Figure 2) showed a tissue mass with very clear borders, infiltrating the hepatic hilum. This mass was pushing the common bile duct back, sheathing the right and particularly the left portal pedicles as well as the bile duct, with no dilatation of the intrahepatic bile ducts and no mass effect on the blood vessels. This lesion had low signal intensity on T1-weighted images with moderate and heterogeneous signal intensity on T2-weighted images: it seemed to contain more hyperintense lesions on T2-weighted images. The contrast-enhanced T1-weighted images showed no enhancement. The endoscopic ultrasound (Figure 3) revealed multiple, oval, coalescent masses at the hepatic pedicle, particularly in front of and behind the portal vein; the largest of these masses had an axis of 3 cm. No fine needle aspiration was carried out on these lesions.Evolution of pain and fever was spontaneously favorable without any treatment, especially antibiotics. There was no explanation of the fever after physical and laboratory examinations. The endoscopic ultrasound ruled out any stones in the gall bladder and common bile duct, which could explain such a high fever. Endoscopic retrograde cholangiography was not performed.Assuming that a low-grade lymphoma, sarcoidosis, an inflammatory pseudotumor of the ganglion, or ganglionic tuberculosis was involved, we performed a surgical biopsy under laparoscopy and finally diagnosed a pri...

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Tumors and Tumor-like Lesions of the Schwann Cell Lineage and the Nerve Sheath

Zimmermann¹

2016

Tumors and Tumor-Like Lesions of the Hepatobiliary Tract

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CASE REPORT: Extrahepatic Biliary Schwannoma

Cited by 23 publications

References 8 publications

Schwannoma of common bile duct causing obstructive jaundice

Schwannoma of common bile duct causing obstructive jaundice

Primary neurofibroma of the common bile duct: a case report

Tumors and Tumor-like Lesions of the Schwann Cell Lineage and the Nerve Sheath

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