Hilar traumatic neuroma masquerading as Klatskin tumor

Rastogi, Archana

doi:10.7869/tg.248

Cited by 3 publications

(7 citation statements)

References 3 publications

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“…Accurate preoperative diagnosis of neuroma can be difficult. Many patients in case reports listed were thought to have an underlying malignancy,6 with elevated CA19-9 and imaging studies concerning for an infiltrative or neoplastic process. In several case reports, a defined enhancing nodule on CT was described,7 which underscored the concern for malignancy.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

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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“…Neuroma is composed of disordered nerve fibers and its signal density is the same as soft tissue and the pancreatic head, thus making it difficult to identify by CT and MRI examinations (19). Just as in our case, the elevation of tumor marker CA19-9 (7) and liver function enzymes (1) makes correct preoperative diagnosis a real challenge.…”

Section: Discussionmentioning

confidence: 68%

“…Surgical excision remains the mainstay treatment of traumatic neuroma, and there is no response to chemotherapy or radiotherapy (3). Due to its rarity and the limitations of specific imaging findings, traumatic neuroma of the biliary tract is most commonly misdiagnosed as cholangiocarcinoma (7), as happened in our case. Neuroma is composed of disordered nerve fibers and its signal density is the same as soft tissue and the pancreatic head, thus making it difficult to identify by CT and MRI examinations (19).…”

Section: Discussionmentioning

confidence: 77%

“…Even though most patients follow an asymptomatic course, some patients present with abnormal liver function, jaundice, pruritus, abdominal pain, weight loss, abnormal urine color, or clay-colored stools ( 1 , 7 ). Our patient presented with abnormal liver function tests.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical excision remains the mainstay treatment ( 3 ). However, traumatic neuroma frequently mimics cholangiocarcinoma and extensive radical surgery is performed ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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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.

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

Ali

Gharib

Hassan

et al. 2023

Med Int

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Laparoscopic cholecystectomy has been found to be associated with the development of traumatic neuromas on rare occasions. The present study reports a rare case of post-cholecystectomy biliary tree traumatic neuroma. Herein, a 47-year-old female with a history of laparoscopic cholecystectomy presented with upper abdominal pain and anorexia. Upon an examination, a yellow discoloration of the sclera was observed. Magnetic resonance cholangiopancreatography revealed a dilated proximal bile duct and mild dilatation of the intrahepatic biliary tree due to a stricture. Intraoperatively, a hard bile duct mass was observed with multiple enlarged lymph nodes in the peri-hepatic region. The patient was initially suspected to have bile duct cancer; however, a histopathological analysis of the resected mass revealed a bile duct traumatic neuroma. Biliary traumatic neuromas may be underestimated since they often remain asymptomatic. It is unfortunate that, as traumatic neuromas often lack distinguishing characteristics, no particular radiological findings for traumatic neuromas of the bile duct have been described to date, at least to the best of our knowledge. The rarity of this condition, combined with the absence of a standardized diagnostic modality, renders its diagnosis difficult and can even lead to misdiagnosis as biliary cancer.

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Hilar traumatic neuroma masquerading as Klatskin tumor

Cited by 3 publications

References 3 publications

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

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

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

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

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