Heterotopic chondroid tissue of the main bile duct mimicking Klatskin tumor: case report and review of the literature

  • Fatma Hüsniye Dilek
  • Şebnem Karasu
  • Osman Nuri DilekEmail author
Case Report


Heterotopic tissue in the bile duct is a very rare condition. There are a few case reports of heterotopic tissue including gastric and pancreatic cells. However, we could not find any data regarding heterotopic chondroid tissue obstructing the common bile duct in the literature. A 56-year-old woman was admitted to our hospital with complaints of progressive jaundice and pruritus. Laboratory test results were within the normal limits except bilirubin and alkaline phosphatase which were 10.8 mg/dL and 256 IU/L, respectively. Endoscopic retrograde cholangiography (ERCP) and computed tomography (CT) revealed a biliary stricture confined to the upper part of the common bile duct. The patient was operated as soon as the bilirubin level dropped below 5 mg/dL by percutaneous transhepatic cholangiography. Despite the lack of a precise confirmation, the patient was prepared for operation considering the possibility of a malignant biliary tumor since the radiographic mass findings together with hyperbilirubinemia were highly suggestive of malignancy. The patient underwent total extrahepatic bile duct resection and Roux-en-Y hepaticojejunostomy, and was discharged without any postoperative complications. Histologic examination of the bile duct and the nodule revealed the presence of a well-demarcated chondroid tissue within the subepithelial connective tissue. Herein, we presented the first case, to our knowledge, of heterotopic chondroid tissue of the common bile duct in the literature. It is a benign condition that should be considered in the differential diagnosis of stricture and mass-forming lesions of the bile duct.


Bile duct Chondroma Heterotopic tissue Jaundice Klatskin tumor 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Human rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

This is a case report. As a routine procedure of our clinic, informed consent has been taken for all condition including treatment modalities and also publication.


  1. 1.
    Corvera CU, Blumgart LH, Darvishian F, et al. Clinical and pathologic features of proximal biliary strictures masquerading as hilar cholangiocarcinoma. J Am Coll Surg. 2005;201:862–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Maeda S, Yamanaka N, Tanaka T, et al. Idiopathic benign biliary stricture. J Hepatobiliary Pancreat Surg. 1998;5:463–6.CrossRefPubMedGoogle Scholar
  3. 3.
    Molinari M, Ong A, Farolan MJ, et al. Pancreatic heterotopia and other uncommon causes of non-malignant biliary obstruction. Surg Oncol. 2000;9:135–42.CrossRefPubMedGoogle Scholar
  4. 4.
    Franceschi T, Allias F, Mauduit C, et al. Chondroid nodule in the female peritoneum arises from normal tissue and not from teratoma or conception product. Virchows Arch. 2018;473:115–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Sumiyoshi T, Shima Y, Okabayashi T, et al. Heterotopic pancreas in the common bile duct, with a review of the literature. Intern Med. 2014;53:2679–82.CrossRefPubMedGoogle Scholar
  6. 6.
    Fukuda S, Mukai S, Shimizu S, et al. Heterotopic gastric mucosa in the hilar bile duct mimicking hilar cholangiocarcinoma: report of a case. Surg Today. 2013;43:91–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Aoki T, Kubota K, Oka T, et al. Follicular cholangitis: another cause of benign biliary stricture. Hepatogastroenterology. 2003;50:639–42.PubMedGoogle Scholar
  8. 8.
    Erdogan D, Kloek JJ, ten Kate FJ, et al. Immunoglobulin G4-related sclerosing cholangitis in patients resected for presumed malignant bile duct strictures. Br J Surg. 2008;95:727–34.CrossRefPubMedGoogle Scholar
  9. 9.
    Fadare O, Bifulco C, Carter D, et al. Cartilaginous differentiation in peritoneal tissues: a report of two cases and review of the literature. Mod Pathol. 2002;15:777–80.CrossRefPubMedGoogle Scholar
  10. 10.
    Spanta R, Lawrence WD. Soft tissue chondroma of the fallopian tube. Differential diagnosis and histogenetic considerations. Pathol Res Pract. 1995;191:174–8.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  1. 1.Department of Pathology, School of Medicineİzmir Katip Çelebi UniversityİzmirTurkey
  2. 2.Department of Radiology, Atatürk Education and Research Hospitalİzmir Katip Çelebi UniversityİzmirTurkey
  3. 3.Department of Surgery, School of Medicineİzmir Katip Çelebi UniversityİzmirTurkey

Personalised recommendations