Traumatic neuroma of the bile ducts with intrahepatic extension causing obstructive jaundice

Larson, Donald M.; Storsteen, Kenneth A.

doi:10.1016/s0046-8177(84)80193-8

Cited by 29 publications

(9 citation statements)

References 8 publications

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“…Possible explanations include the growth and extension of epithelial structures along planes that offer less resistance, such as the perineural space, or the proliferation of nerve trunks with extension into the epithelial structures. Hyperplastic nerve trunks have the ability to infiltrate tissues, as has been reported to occur in traumatic neuromas 18. At the biochemical level the migration of metaplastic pyloric glands to the nerve trunks or vice versa may be related to the production of chemotactic factors or signaling substances and the activation of cell receptors 19.…”

Section: Discussionmentioning

confidence: 91%

Pyloric gland metaplasia with perineural invasion of the gallbladder

Albores‐Saavedra

Henson

1999

Cancer

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BACKGROUND Metaplastic pyloric glands have been described in a variety of organs including the gallbladder, in which they can extend into the muscular wall and serosa. METHODS Clinical, histologic, and immunohistochemical features of four cases of gallbladder florid pyloric gland metaplasia with perineural and intraneural invasion are analyzed. RESULTS The patients with pyloric gland metaplasia and perineural and intraneural invasion were all females ages 57–72 years. A preoperative diagnosis of chronic cholecystitis and cholelithiasis was made for all four patients, but a histologic diagnosis of adenocarcinoma was made for two patients and entertained in two others. Macroscopically the gallbladders showed changes usually associated with chronic cholecystitis. No intraluminal masses were observed in any of the gallbladders. The characteristic microscopic features included florid pyloric gland metaplasia, proliferation of medium‐sized nerve trunks more prominent in the muscular layer and serosa, and perineural and intraneural invasion by the metaplastic glands lined by cytologically bland cuboidal or columnar mucin‐containing cells. At last follow‐up all patients were alive and symptom free 1‐7 years after laparoscopic cholecystectomy. CONCLUSIONS Pyloric gland metaplasia of the gallbladder should be added to the long and increasing list of benign epithelial proliferations that are associated with perineural and intraneural invasion. This lesion should not be mistaken for adenocarcinoma of the gallbladder, a misinterpretation that may have serious therapeutic implications. The pathogenesis of this phenomenon is unknown. Cancer 1999;86:2625–31. © 1999 American Cancer Society.

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Section: Discussionmentioning

confidence: 91%

Pyloric gland metaplasia with perineural invasion of the gallbladder

Albores‐Saavedra

Henson

1999

Cancer

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“…Traumatic neuroma of the biliary tree was first described by Husseinoff in 1928. [4] Cholecystectomy is the most frequently performed operation in abdominal surgery [6] Neuromas have been most commonly described after both laparoscopic and open cholecystectomy.…”

Section: Discussion:-mentioning

confidence: 99%

A Case of Traumatic Neuroma of the Common Biliary Duct Simulating a Cholangiocarcinoma

Najioui¹,

Miry²,

Tiabi³

et al. 2021

IJAR

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We present a case of traumatic neuroma of the common bile duct in a 53-year-old woman who presented with jaundice,5months after cholecystectomy. Physical examination revealed jaundice, epigastric pain and scratching lesions. Gamma glutamyl transferase (GGT) at 109 U/L, Alkaline phosphatase at 175U/L. CA19-9 was at 500U/mlMagnetic resonance cholangiopancreatography revealed a T1 and T2hyperintense lesion of peri-hilar fat. An increase in intensity was noted after useof gadolinium.Exploratory laparotomy was performed with the presumptive diagnosis of cholangiocarcinoma. Pathologic analysis of the surgical specimen revealed Haphazard mature nerves, consistent with a bile duct neuroma. Follow-up of the patient showed no post-operative complications or signs of recurrence.

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“…The majority of the reported cases involved the extrahepatic or common bile duct (66%) [3, 10, 12-26] and the stump of the cystic duct [6, 8, 9, 11, 27-30]. In other cases, the neuromas involved the right hepatic duct [31], both intrahepatic and extrahepatic bile ducts [2, 16, 32], the cystic duct [33] or the surrounding tissues (e.g., hepatoduodenal ligament [13]or biliodigestive anastomosis [17]). Rare unusual cases reported in the literature are neuromas arising in the gallbladder due to an unsuccessful cholecystectomy performed 20 years previously [34]and a bile duct neuroma that developed in a remnant choledochal cyst associated with total agenesis of the dorsal pancreas [35].…”

Section: Discussionmentioning

confidence: 99%

Diffuse Neuromatosis of Intrahepatic and Extrahepatic Bile Ducts as a Rare Cause of Jaundice

et al. 2020

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Background: Neuroma of the biliary tree is extremely rare with no more than 100 cases reported so far. They mostly present with obstructive jaundice and have been commonly described after surgery or abdominal trauma. Although involvement of the extrahepatic bile duct is far more common, occurrence in the intrahepatic ducts has not so far been reported. Case Report: We describe 3 cases of diffuse biliary tree neuroma affecting 3 females aged 53–68 years. None had a history of neurofibromatosis type1. All presented with progressive obstructive jaundice with no evidence of gallstones. A history of previous surgery was noted in 2 patients. Initial impression on clinical and imaging examination was highly suspicious for bile duct carcinoma in 2 patients. Histology showed diffuse neuromatous proliferation replacing and thickening the bile duct walls. The third patient had concurrent neuroma and recurrent cholangiocarcinoma causing great clinical confusion as initial biopsy showed only benign neuroma, but CA 19-9 was steadily increasing, necessitating a second biopsy which then confirmed recurrent carcinoma. Conclusion: This uncommon cause of long-distance bile duct stenosis and progressive jaundice should be included in the differential diagnosis of bile duct neoplasms, in particular when there is a previous surgical history in this abdominal region.

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Traumatic neuroma of the bile ducts with intrahepatic extension causing obstructive jaundice

Cited by 29 publications

References 8 publications

Pyloric gland metaplasia with perineural invasion of the gallbladder

Pyloric gland metaplasia with perineural invasion of the gallbladder

A Case of Traumatic Neuroma of the Common Biliary Duct Simulating a Cholangiocarcinoma

Diffuse Neuromatosis of Intrahepatic and Extrahepatic Bile Ducts as a Rare Cause of Jaundice

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