Villous adenoma of common bile duct

Jao, Yeun Tarl Fresner Ng; Tseng, Li‐Jung; Wu, Chia-Jen; Young, Ta-Ming; Wang, Chun‐Hsiang; Wey, Keh-Cherng

doi:10.1067/mge.2003.90

Cited by 8 publications

(6 citation statements)

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“…One of our cases has been reported previously 1 . On extensive review of the literature, we found another 36 cases making a total of 39 cases of extrahepatic biliary adenomas reported to date 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ( Table1 and Fig. 4 ).…”

Section: Discussionmentioning

confidence: 97%

“…One of our cases presented with recurrent bacteremia in the setting of underlying primary sclerosing cholangitis. Two reported cases were asymptomatic with incidental findings of biliary dilation on imaging 1 8 . One case was found incidentally in a surgical resection specimen performed for duodenal adenocarcinoma 11 .…”

Section: Demographics and Presentationmentioning

confidence: 97%

“…The age of presentation ranged from 15 to 85 years with a mean age of 62.8 ± 15.4 years (male, 61.0 ± 14.4 years; female, 64.6 ± 16.3 years). The affected gender was male in 21 cases 4 5 8 10 11 13 15 16 19 21 25 27 and female in 18 cases 2 3 6 7 9 12 14 17 18 20 23 24 26 27 . The most common presenting complaints were abdominal pain, jaundice, fever, pruritus, and abnormal LFTs.…”

Section: Demographics and Presentationmentioning

confidence: 99%

“…In 22 cases, the adenomas were associated with atypia/dysplasia. The location of adenomas was in the CBD (25/39; 64 %) 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 , common hepatic duct (7/39; 18 %) 3 17 18 19 20 21 22 23 24 , and cystic duct (3 /39; 8 %) 22 23 24 . Four (10 %) cases involved multiple ducts in continuity 25 26 27 28 .…”

Section: Histologymentioning

confidence: 99%

“…Cases in the 1970 s have reported using limited surgical curettage without resection of the affected area 3 5 . Endoscopic resection with snare polypectomy or forceps has been reported in six cases 6 8 14 15 16 24 . There are no reports of the use of ablative therapy with radiofrequency ablation or photodynamic therapy after endoscopic resection.…”

Section: Treatmentmentioning

confidence: 99%

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Adenomas involving the extrahepatic biliary tree are rare but have an aggressive clinical course

et al. 2015

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Biliary adenomas that are usually found in surgically removed gallbladders are rare, but can also occur in the extrahepatic biliary tree. We present a case series of extrahepatic bile duct adenomas at our institution, along with a review of the literature. All three patients with extrahepatic biliary adenomas (two in the common bile ducts, one in the hepatic duct) were female with a mean age of 74 years. On initial presentation, none of the patients had obstructive jaundice but two of the three patients had symptoms of biliary origin. Case 1 is an 85-year-old woman with an incidental biliary dilation seen on chest imaging; endoscopic ultrasound revealed a sessile adenomatous polyp in the distal bile duct. The patient refused surgery and presented with occlusive biliary stricture and jaundice 5 months after initial presentation, with cytology confirming malignant progression. Case 2 is a 78-year-old woman with a history of primary sclerosing cholangitis and who presented with cholangitis, and Gram-negative sepsis. A polypoid lesion was seen on imaging in the common hepatic duct and direct cholangioscopy with biopsies confirmed the presence of adenoma with high grade dysplasia. The patient underwent successful total bile duct resection and hepaticojejunostomy but represented 1 year later with diffuse metastatic disease to the bone, liver, and peritoneum. Case 3 is a 61-year-old woman who presented with symptoms suggestive of gallbladder pathology and was found to have a polypoid bile duct lesion on intraoperative cholangiogram. Endoscopic retrograde cholangioscopy showed an adenomatous polyp with high grade dysplasia involving the distal common bile duct. The patient underwent distal bile duct resection with choledochojejunostomy but presented with jaundice 4 years after surgery. She was found to have adenocarcinoma involving the small bowel in the Roux limb of jejunum and transverse colon. All three patients in our series presented with interval gastrointestinal malignancy and we therefore recommend aggressive surgical intervention and close postoperative surveillance when diagnosis of extrahepatic bile duct adenoma is made.

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