Heterotopic pancreas: A rare cause of bile duct dilatation —Report of a case and review of the literature—

A case of a 77 year old woman with a heterotopic pancreas in the distal common bile duct is reported herein. The patient had no symptoms, but an ultrasound examination showed bile duct dilatation and subsequent endoscopic retrograde cholangiography demonstrated a spherical filling defect in the distal common bile duct. Under suspicion of a benign neoplasm in the common bile duct, resection of the common bile duct and hepaticojejunostomy using a Roux-en Y jejunal limb were successfully performed. Pathological examination revealed heterotopic pancreatic tissue in the distal common bile duct. This is only the ninth reported case of heterotopic pancreas occurring in the common bile duct or ampulla of Vater, and thus, a review of the literature is also given.     

Heterotopic pancreas as a rare cause of gastrointestinal hemorrhage in the newborn: Report of a case

We report herein a female infant in whom a heterotopic pancreas in the stomach caused gastrointestinal hemorrhage during the newborn period. Endoscopy was essential for ruling out other causes of hemorrhage and to follow the patient until the time of elective surgery at 6 months of age. Heterotopic pancreas should be borne in mind as a rare cause of gastrointestinal hemorrhage in the newborn when an unexplained gastrointestinal hemorrhage continues, and the lesion was discussed in relation to our experience of upper gastrointestinal endoscopies and a review of the literature.     

Carcinosarcoma of the bile duct: a case report and review of literature

Carcinosarcomas of the bile ducts are very rare tumors consisting of both epithelial and mesenchymal elements. We report a case of bile duct carcinosarcoma and its clinical, radiological and pathological features and a brief review on this rare condition.     

初诊胆道蛔虫的罕见胆总管变异1例报告并文献复习

背景与目的 临床上,胆道系统尤其是胆囊的变异比较常见,但是胆总管变异却罕见。本文报告1例初诊为胆道蛔虫的罕见胆总管变异患者的临床资料和诊治经过,以期提高对胆总管变异的认识和诊治准确性。方法 回顾性分析2019年1月贵州省人民医院肝胆外科收治的1例初诊为胆道蛔虫的罕见胆总管变异患者的临床资料和诊治经过。结果 患者为60岁老年女性,以“腹腔镜胆囊切除术后上腹痛伴巩膜黄染20 d余”为主诉入院。患者入院后结合外院磁共振成像（MRI）+磁共振胆胰管成像（MRCP）检查结果初步考虑诊断为“胆道蛔虫”。但患者临床表现不典型,与胆道蛔虫经典的剑突下钻顶样疼痛不符,且患者上腹有压痛,结合入院后的B超检查结果未提示胆总管内有异常回声等,不排除胆总管其他异常情况可能。为明确诊断和进一步治疗,为患者施行了内镜逆行胰胆管造影（ERCP）检查。ERCP检查确诊为罕见的胆总管变异,后经护肝、护胃、增加胃动力、解痉止痛、通便等治疗后治愈出院。电话随访3年半患者未再出现黄疸等不适。结论 对不典型的胆总管情况需警惕罕见胆总管变异的可能,以提高对胆总管疾病的准确诊治。     

Carcinoids of the common bile duct: a case report and literature review.

Carcinoids of the extrahepatic bile ducts and particularly the common bile duct are extremely rare. A 65-year-old woman presented with obstructive jaundice. Laboratory and imaging studies gave results that were consistent with an obstructing lesion in the common bile duct. In this case, a stent was inserted initially to decompress the bile ducts. Subsequently a laparotomy and pancreaticoduodenectomy were performed and a tissue diagnosis of carcinoid of the common bile duct was made. The patient was well with no evidence of recurrence 17 months postoperatively. The authors believe this is the 19th reported case of an extrahepatic bile duct carcinoid.     

Double common bile duct: a case report and a review of the Japanese literature

BACKGROUND: A double common bile duct (DCBD) is a rare congenital anomaly. We report the case of a 60-year-old Japanese female, whose common bile duct divided into 2 channels and both channels opened individually into the second portion of the duodenum. This is the fourth reported case of DCBD with a choledochal cyst and pancreaticobiliary maljunction (PBM). METHODS: A review of the literature revealed that DCBD is more frequently diagnosed in Oriental people. We reviewed 47 cases of DCBD reported in the Japanese literature. RESULTS: Among these, cholelithiasis was found in 27.7%, a choledochal cyst in 10.6%, PBM in 29.8%, and cancers in 25.5%. Cancer and PBM were the 2 most serious concomitant conditions. The incidence and type of complicating cancer and PBM varied according to the site of the opening of the accessory common bile duct (ACBD). Concomitant gastric cancer was frequently noted when the ACBD opened into the stomach, whereas cancer of the biliary system was common when the ACBD opened into the second portion of the duodenum or the pancreatic duct. PBM was observed only in those patients in whom the ACBD opened into the second portion of the duodenum or the pancreatic duct. Therefore the treatment and prognosis of DCBD is influenced by the site of opening of the ACBD. CONCLUSIONS: In DCBD, the opening site of the ACBD was considered to have close implications for the type of concomitant cancer and concomitant PBM that would appear.     

Neurofibroma of the bile duct: a rare cause of obstructive jaundice

Neurofibromas of the common bile duct are extremely rare. The lack of specific clinical or radiological features makes preoperative diagnosis in the absence of histology difficult. We report the case of a female patient who presented with obstructive jaundice and evidence of a common bile duct stricture on imaging. She underwent an exploratory laparotomy, and intraoperative frozen section confirmed clear margins and a benign lesion. Excision of the extrahepatic bile duct and A Roux-en-Y hepaticojejunostomy was performed. We discuss the clinical features and management of neurofibromas of the bile duct in light of the literature.     

Common bile duct MALT lymphoma: case report and review of the literature

We report a rare case of common bile duct mucosa-associated lymphoid tissue (MALT) lymphoma treated with pancreatico-duodenectomy with a partial gastrectomy. MALT lymphoma involving the biliary tree is extremely rare. Diagnosis is difficult and treatment options are controversial. Even though Helicobacter pylori treatment is effective in the early stages of the disease, surgery is still helpful especially when obstruction, perforation, or bleeding is present.     

Common bile duct adenoma: case report and brief review of literature

Papillary adenomas of the common bile duct are a rare entity with few published case reports and limited knowledge on its natural progression. We report here a case of common bile duct papillary adenoma in a 69-year-old female who presented with symptoms of common bile duct obstruction. She was treated with local endoscopic excision of the mass that has benign features. A brief review of literature is discussed with a proposed treatment plan for follow-up with surveillance endoscopy and ultrasonography as opposed to the radical resection for benign findings on pathology.     

胆管周围孤立性纤维瘤一例及文献复习

孤立性纤维瘤(solitary fil3rous tumor,SFT)是一种少见的梭形细胞软组织肿瘤,1931年由Klemperer和Rabin最初报道发生在胸膜[1].随后的报道表明,SFT可以发生于全身多个部位.我院近期收治1例胆管周围孤立性纤维瘤,现报道如下. 患者男,52岁.因"右上腹不适伴全身皮肤黄染两周"入院.两周前出现腹部胀痛,逐渐加重,并逐渐出现尿黄,巩膜、全身皮肤黏膜黄染,大便呈白陶土样改变.无畏寒、发热,无呕血、便血.体重减轻约3 kg.既往无肝炎、结核病史.查体:神志清,巩膜及全身皮肤黏膜黄染.腹部平软,肝脾肋下未及,未扪及包块,右上腹轻压痛,无反跳痛,Murphy征阴性,移动性浊音阴性,肠鸣音不亢进.血常规无异常.     

Neurofibroma of the common bile duct: a rare cause of obstructive jaundice

Neurofibroma of the common bile duct is extremely rare. Fewer than 20 cases have been reported in the literature. We report a case of neurofibroma in a 47-year-old female presented with obstructive jaundice. Preoperative imaging failed to diagnose the case. The patient was treated with en-bloc excision of the extrahepatic biliary tree and Roux-en-Y hepaticojejunostomy.     

Carcinoid tmour of the common bile duct: report of a case and a review of the literature

Carcinoid tumours of the common bile duct are extremely rare lesions. In this article we report a case with an extrahepatic bile duct carcinoid tumour. A 40-year-old woman suffered from biliary colic and jaundice. Pre-operative computed tomography demonstrated a tumour in the biliary tract. At laparotomy there was a tumour invading the common bile duct. Common bile duct resection was performed. Carcinoid tumour of the common bile duct was diagnosed histopathologically. For extrahepatic bile duct carcinoid tumours surgical resection is the only treatment modality that offers a chance to provide a cure and prolonged disease-free survival. The favourable histopathological and biological features of these tumours encouraged the surgeons to use more aggressive approaches for advanced disease.     

Mixed ductal-endocrine carcinoma of the pancreas with synchronous papillary carcinoma-in-situ of the common bile duct: a case report and literature review--synchronous pancreatic and bile duct tumors

This report is a case of a 58-year-old woman with a mixed ductal-endocrine carcinoma of the pancreas and a synchronous carcinoma-in-situ of the common bile duct. She presented with intractable itching from obstructive jaundice. Magnetic resonance imaging scan showed dilated intrahepatic biliary and common bile ducts. Endoscopic retrograde cholangiopancreatography revealed an ulcerated lesion of the ampulla. Biopsies from this lesion showed adenocarcinoma. Subsequently, pancreatoduodenectomy was performed for the diagnosis of peri-ampullary carcinoma. Gross examination revealed a 2-cm irregular, ulcerated lesion obstructing the distal 0.5 cm of the common bile duct within the head of the pancreas. On histopathological examination, it was discovered that this lesion contained two separate neoplasms: papillary carcinoma-in-situ of the intraparenchymal portion of the common bile duct and a mixed ductal-endocrine carcinoma of the pancreas. Mixed ductal-endocrine carcinoma of the pancreas is very rare. Finding it in conjunction with a synchronous, overlying papillary carcinoma carcinoma-in-situ of the common bile duct has not been previously described.     

An unusual cause of hydropic gallbladder and biliary colic — Heterotopic pancreatic tissue in the cystic duct: Report of a case and review of the literature

We present herein an unusual case of heterotopic pancreas in the cystic duct with hydrops of the gallbladder and concomitant chronic pancreatitis of the heterotopic tissue. A review of the relevant literature is discussed following the presentation of this case.     

Undifferentiated carcinoma of the common bile duct: case report and review of the literature

A 78-year-old Japanese man with undifferentiated carcinoma of the common bile duct is presented. Upon gross examination, the common bile duct was found to be obstructed by a nodule measuring 10 x 10 mm. Microscopically, the nodule was ill-defined and composed of atypical spindle-shaped and pleomorphic tumor cells. The spindle-shaped cells proliferated in a whirled or interlacing pattern simulating a sarcoma, and the pleomorphic tumor cells had abundant eosinophilic cytoplasm and bizarre nuclei. Histochemically, a few tumor cells contained mucosubstances stained with the alcian blue (AB) method in their cytoplasm. Immunohistochemically, the tumor cells were diffusely positive for CAM5.2 and AE1/AE3. The histological diagnosis was undifferentiated carcinoma (spindle cell carcinoma) of the common bile duct. Other than our patient, only four other cases of undifferentiated carcinoma in the extrahepatic bile duct have been reported in the literature.     

Carcinoid of the extra-hepatic bile duct: a case report with long-term follow-up and review of literature

Extrahepatic bile duct tumors, 80 per cent of which are adenocarcinomas, are rare neoplasms accounting for less than two per cent of all cancers. Carcinoid tumor of the extrahepatic bile ducts is a reportable lesion, with only approximately 50 cases described in the literature since 1959. We present a case of a primary extrahepatic bile duct carcinoid tumor resected for cure with the longest reported follow-up time (11 years) after surgery. We also summarize the existing literature with regard to this rare tumor. Our case lends strong support to the notion that extrahepatic biliary carcinoids are generally indolent lesions that, if aggressively resected, can result in excellent long-term survival. Complete excision with clear margins seems to provide the best chance of obtaining long-term survival and cure.     

Carcinoid tumor of the bile duct. A case report and literature review

A 35-year-old woman presented with painless jaundice that on evaluation was attributed to a tumor at the confluence of the hepatic ducts. There was no evidence of tumor spread on preoperative workup. The tumor was resected and histologically was typical for carcinoid. There have been only ten previously described cases of bile duct carcinoid tumors excluding gallbladder and ampullary lesions. This study presents a discussion of the management of these tumors and a review of the literature.