| Autor: |
Fabio, Colombo, Barbara, Carrara, Stenio, Rosato, Ferdinando, Rück, Andrea, Simonetti, Matteo, Soccio, Giuliano, Taverniti, Maria Candida, Zeppieri |
| Rok vydání: |
2007 |
| Předmět: |
|
| Zdroj: |
Chirurgia italiana. 59(3) |
| ISSN: |
0009-4773 |
| Popis: |
Carcinoid tumors of the extrahepatic bile ducts are extremely rare and account for only 0.2-2% of all gastrointestinal endocrine neoplasms. They are particularly difficult to diagnose preoperatively and distinguish from cholangiocarcinoma. We report the case of a 52-year-old patient with a carcinoid tumour of the common bile duct presenting with obstructive jaundice. Laboratory and imaging studies (US, CT, MRI) showed an obstructive lesion measuring 2 cm in diameter in the common bile duct. A biliary stent was inserted initially to decompress the bile ducts. Brushing was negative for malignant cells. With a suspicion of malignancy (confirmed intraoperatively), the patient underwent radical resection of the extrahepatic duct, portal lymphadenectomy and a Roux-en-Y hepaticojejunostomy. The pathology examination revealed a well-differentiated neuroendocrine tumour of the common hepatic duct. The tumour cells were immunopositive for chromogranin A and synoptophysin. There was no evidence of metastases in the nodes removed and negative surgical margins were achieved. The patient is disease-free after a follow up of 3 months, and levels of chromogranin A and neuron-specific enolase are normal. Local and systemic aggressiveness of these tumours is rare. Radical surgery offers the only chance of a cure and has to be considered whenever possible. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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