Case Report: Idiopathic Traumatic Neuroma of the Gallbladder Without Previous Surgery

Abstract

Traumatic neuroma mostly results from nerve injury caused by surgery or trauma. Traumatic neuroma of the gallbladder without prior abdominal surgery is extremely rare, and we termed it “idiopathic traumatic neuroma of the gallbladder.” Due to its rarity and a lack of specific clinical and radiological features, it is most commonly misdiagnosed. In our case, the patient was admitted to our hospital for cholangiocarcinoma. Repeated abdominal contrast-enhanced computed tomography scans preoperatively indicated hilar cholangiocarcinoma. Due to insufficient future liver remnant, we planned preoperative percutaneous transhepatic cholangiodrainage and percutaneous transhepatic portal vein embolization based on multidisciplinary team consultation. The patient was then admitted 1 month later for surgery. We performed a laparoscopic cholecystectomy and an extensive laparoscopic right hepatectomy as gallbladder carcinoma was strongly suspected intraoperatively. However, the final diagnosis was traumatic neuroma of the gallbladder confirmed by pathological examination. Traumatic neuroma of the gallbladder is very rare, and we hope to provide some references for diagnosis by reporting our case and reviewing the literature on this topic so that extensive treatment can be avoided, thus improving patients’ quality of life. To the best of our knowledge, this is the first reported case of traumatic neuroma without prior surgery in the English literature since 1996.

Biliary tree traumatic neuroma following laparoscopic cholecystectomy: A case report and literature review

“…Adults can develop extra-hepatic bile duct strictures as a result of malignant or benign biliary tumors ( 4 ). Invasive adenocarcinoma is the most frequent cause of primary biliary tumors, while benign tumors, such as adenomas and papillomas are significantly less common, accounting for only 6% of all biliary tumors ( 4 , 7 ). Biliary tree traumatic neuroma is a rare benign, poorly defined, non-encapsulated lesion with an unregulated proliferation of all normal components of the nerve bundle, such as enlarged masses of axons, endoneurial cells, Schwann cells, and perineural cells in a rich collagenous matrix ( 8 , 9 ).…”

“…The interval in the current case was only 4 weeks. Traumatic neuroma, often known as amputation neuroma, is exceedingly rare in the gallbladder without preceding surgery or cholelithiasis ( 7 ). Although the pathophysiology of biliary traumatic neuroma has been shown to be associated with the process of nerve regeneration, potential mechanisms encouraging its production remain unclear.…”