Neuroendocrine tumor of the common bile duct: a case report and review of the literature

Abstract

We report a rare case of neuroendocrine tumor (NET) in the common bile duct (CBD). The patient is a 56-year-old female who presented to our department with symptoms of fever but without jaundice. A preoperative examination showed a tumor in the CBD. The tumor volume was almost 5.5 × 4.5 × 4 cm3, which is the biggest NET in the CBD reported on PubMed. The imaging results (computed tomography [CT] and magnetic resonance imaging [MRI]) were not consistent with CBD adenocarcinoma. The tumor appeared to oppress the growth of the CBD rather than originate in the bile duct wall; combined with the low blood bilirubin index and lack of jaundice symptoms, the preoperative diagnosis was not clear. We performed a radical resection of the cholangiocarcinoma. The patient recovered well before going home. The pathology was NET (Grade 2). The patient showed no recurrence to date, without intravenous chemotherapy (8 months).

Preoperative diagnosis of well‐differentiated neuroendocrine tumor in common hepatic duct by brush cytology: A case report

“…21 Since Pilz reported the first case of biliary NET in 1961, a review of the literature revealed only 92 previously reported cases. [2][3][4] The reason for the rarity of NET in the biliary tree is explained by the fact that chromaffin and Kulchitsky cells, which are the origin of NET, are rarely present in the biliary tree. 22 In the digestive system, the 2010 WHO classified neuroendocrine neoplasms as G1, G2, or G3 according to the proliferative activity measured by counting mitosis or evaluating the Ki-67 LI.…”

“…In a review by Michalopoulos et al, preoperative diagnosis was reported to be feasible in only four of 78 cases based on elevated serum serotonin levels (two cases) and biopsy during endoscopic retrograde cholangiopancreatography (ERCP) (two cases). To the best of our knowledge, no previously reported biliary NET cases have described preoperative brush cytology . Herein, we report on brush cytology of NET in the common hepatic duct (CHD).…”

“…The biological behavior and prognoses of NET G1/G2 are very different from those of NEC as well as adenocarcinoma in the digestive system; however, NET in the biliary tree is poorly understood due to their rarity. The clinical symptoms were mostly related to biliary obstruction but not hormone secretion . Preoperative diagnosis of NET in the biliary tree is almost impossible due to the non‐specific clinical symptoms and lack of tumor markers.…”

“…The clinical symptoms were mostly related to biliary obstruction but not hormone secretion. 2 Preoperative diagnosis of NET in the biliary tree is almost impossible due to the non-specific clinical symptoms and lack of tumor markers. In a review by Michalopoulos et al, 6 preoperative diagnosis was reported to be feasible in only four of 78 cases based on elevated serum serotonin levels (two cases) and biopsy during endoscopic retrograde cholangiopancreatography (ERCP) (two cases).…”

“…To the best of our knowledge, no previously reported biliary NET cases have described preoperative brush cytology. [2][3][4][7][8][9][10][11][12] Herein, we report on brush cytology of NET in the common hepatic duct (CHD). Figure 3C) of the tumor cells were detected in the primary tumor site but all lymph nodes were free from tumor metastasis.…”