Bile duct schwannoma developed in the remnant choledochal cyst—a case associated with total agenesis of the dorsal pancreas

Otani, Taiichi; Shioiri, Tsutomu; Mishima, Hideki; Ishihara, Akira; Maeshiro, Tsuyoshi; Matsuo, Akinobu; Umekita, Nobutaka; Warabi, Masahiro

doi:10.1016/j.dld.2004.12.017

Cited by 23 publications

(9 citation statements)

References 18 publications

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“…But in our case the nuclear palisading pattern was present with predominant Antoni A areas. As this is a curable tumor, resection remains the only treatment of choice [3,9]. In our patient, resection of CBD along with the tumor followed by Roux-en-Y hepaticojejunostomy was performed.…”

Section: Discussionmentioning

confidence: 92%

“…CT scan and / or magnetic resonance imaging (MRI) are required to establish the cause of CBD obstruction. Final confirmatory diagnosis is only by histopathology and schwannomas originating from the digestive tract show distinct histological features that distinguish them from conventional schwannomas [8,9]. They are S-100 protein positive spindle cell tumors that are composed mainly of cellular (Antoni A) areas and generally do not show a nuclear palisading pattern that is usually found in conventional schwannomas of the soft tissues [9].…”

Section: Discussionmentioning

confidence: 99%

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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: 92%

Section: Discussionmentioning

confidence: 99%

Schwannoma of common bile duct causing obstructive jaundice

et al. 2010

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“…10 A case report of a neurofibroma of the common bile duct, at a follow-up 15 years after surgical treatment of a type Ic Todani choledochal cyst, with an associated anomaly of the biliopancreatic junction, by choledocojejunostomy with Y-en-Roux anastomosis, forms a singular pathophysiological model. 11 The quasiexclusive location of the common bile duct and the cyst at the head of the pancreas having made bile derivation necessary, the neurofibroma was formed by chronic reflux of pancreatic fluid into the residual cyst.…”

Section: Discussionmentioning

confidence: 99%

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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“…For example, a bile duct Schwannoma that developed 15 years after bypass operation and diversion of bile from a choledochal cyst has been reported [8] . Carcinoma of the papilla of Vater after choledochoduodenostomy for PBM is also very rare and has never been previously reported.…”

Section: C B Amentioning

confidence: 99%

“…However, it has been reported that residual bile duct cancer could be found during the long-term follow-up period, even after termination of pancreatic enzyme reflux [4][5][6] , and Watanabe et al [6] reported that 23 (0.7%) of 1291 patients developed residual bile duct cancer after cyst excision. Besides residual bile duct cancer, other periampullary carcinomas have been reported, but they are very rare [7,8] .…”

Section: Introductionmentioning

confidence: 99%

Carcinoma of the papilla of Vater following treatment ofpancreaticobiliary maljunction

Watanabe¹,

Midorikawa²,

Yamano³

et al. 2009

WJG

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Pancreaticobiliary maljunction (PBM) is frequently associated with biliary cancer due to reflux of pancreatic enzymes into the choledochus, and even after surgery to correct the PBM such patients still have a risk of residual bile duct cancer. Here, we report the case of a 59-year-old female with carcinoma of the papilla of Vater which developed 2.5 years after choledochoduodenostomy for PBM. During the postoperative follow-up period, computed tomography obtained 2 years after the first operation demonstrated a tumor in the distal end of the choledochus, although she did not have jaundice and laboratory tests showed no abnormalities caused by the previous operation. As a result, carcinoma of the papilla of Vater was diagnosed at an early stage, followed by surgical cure. For early detection of periampullary cancer in patients undergoing surgery for PBM, careful long-term followup is needed.

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Bile duct schwannoma developed in the remnant choledochal cyst—a case associated with total agenesis of the dorsal pancreas

Cited by 23 publications

References 18 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

Carcinoma of the papilla of Vater following treatment ofpancreaticobiliary maljunction

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