Skip to main content
SpringerLink
Log in

Neuroendocrine neoplasms of the extrahepatic bile duct: radiologic and clinical characteristics

  • Published:
Abdominal Imaging Aims and scope Submit manuscript

Abstract

Purpose

To retrospectively identify the radiological and clinical features of neuroendocrine neoplasms of the extrahepatic bile duct.

Materials and methods

Institutional review board approval was obtained. Between August 2003 and August 2013, 11 patients (range 41–79 years) who had undergone surgery in our institution for neuroendocrine neoplasms of the extrahepatic bile duct were identified. Clinical features (symptoms, laboratory finding, and medical history) were reviewed. A pathologist reviewed the pathology of 11 patients. CT (n = 11), MRI (n = 10), and PET/CT (n = 8) were reviewed by two radiologists in consensus. They were blinded to the clinical features and pathology report. The tumor location was assessed on CT and was classified as occurring in the common hepatic duct, cystic duct, and common bile duct. The tumor shape was assessed in ten patients using MRI and in one patient using CT. The shape was classified as nodular, intraductal-growing, and periductal-infiltrating type. The FDG activity on PET/CT was also evaluated. Correlation of image findings with pathology was made by a radiologist who didn’t participate in the image analysis.

Results

There were five men and six women and their median age was 65 years. On pathology examination, seven patients had neuroendocrine carcinoma (64%), three had mixed adenoneuroendocrine carcinoma (27%), and one had neuroendocrine tumor (9%). CT showed that the tumors were located in the common bile duct in seven patients (64%), the common hepatic duct in two (18%), and the cystic duct in two patients (18%). Five tumors were classified as nodular (45%), five as intraductal-growing (45%), and one as periductal-infiltrating type (9%). PET/CT showed increased FDG activity, ranging from 2.7–15.9, in eight patients with neuroendocrine carcinoma.

Conclusion

The most common location of neuroendocrine neoplasms of the extrahepatic bile duct is the common bile duct. Most of them are nodular or intraductal-growing type.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Lawrence B, Gustafsson BI, Chan A, et al. (2011) The epidemiology of gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin North Am 40(1):1–18

    Article  PubMed  Google Scholar 

  2. Hauso O, Gustafsson BI, Kidd M, et al. (2008) Neuroendocrine tumor epidemiology: contrasting Norway and North America. Cancer 113(10):2655–2664

    Article  PubMed  Google Scholar 

  3. Bosman FT, Carneiro F, Hruban RH, Theise ND (2010) WHO classification of tumours of the digestive system. In: Komminoth P (ed) Neuroendocrine neoplasms of the gallbladder and extrahepatic bile duct, 4th edn. International Agency for Research on Cancer Press, Lyon, pp: 274–276.

  4. Shia J, Tang LH, Weiser MR, et al. (2008) Is nonsmall cell type high-grade neuroendocrine carcinoma of the tubular gastrointestinal tract a distinct disease entity? Am J Surg Pathol 32(5):719–731

    Article  PubMed  Google Scholar 

  5. Lim JH (2003) Cholangiocarcinoma: morphologic classification according to growth pattern and imaging findings. AJR 181(3):819–827

    Article  PubMed  Google Scholar 

  6. Rindi G, Kloppel G, Couvelard A, et al. (2007) TNM staging of midgut and hindgut (neuro) endocrine tumors: a consensus proposal including a grading system. Virchows Arch 451(4):757–762

    Article  CAS  PubMed  Google Scholar 

  7. Edge SB (2010) American Joint Committee on Cancer. AJCC cancer staging manual, 7th edn. New York: Springer, pp 211–233

    Google Scholar 

  8. Lu DS, Reber HA, Krasny RM, Kadell BM, Sayre J (1997) Local staging of pancreatic cancer: criteria for unresectability of major vessels as revealed by pancreatic-phase, thin-section helical CT. AJR 168(6):1439–1443

    Article  CAS  PubMed  Google Scholar 

  9. Engels JT, Balfe DM, Lee JK (1989) Biliary carcinoma: CT evaluation of extrahepatic spread. Radiology 172(1):35–40

    Article  CAS  PubMed  Google Scholar 

  10. Kim JE, Lee JM, Kim SH, et al. (2010) Differentiation of intraductal growing-type cholangiocarcinomas from nodular-type cholangiocarcinomas at biliary MR imaging with MR cholangiography. Radiology 257(2):364–372

    Article  PubMed  Google Scholar 

  11. Maggard MA, O’Connell JB, Ko CY (2004) Updated population-based review of carcinoid tumors. Ann Surg 240(1):117–122

    Article  PubMed Central  PubMed  Google Scholar 

  12. Tsai HJ, Wu CC, Tsai CR, et al. (2013) The epidemiology of neuroendocrine tumors in Taiwan: a nation-wide cancer registry-based study. PloS One 8(4):e62487

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Cho MY, Kim JM, Sohn JH, et al. (2012) Current trends of the incidence and pathological diagnosis of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) in Korea 2000–2009: multicenter study. Cancer Res Treat 44(3):157–165

    Article  PubMed Central  PubMed  Google Scholar 

  14. Barron-Rodriguez LP, Manivel JC, Mendez-Sanchez N, Jessurun J (1991) Carcinoid tumor of the common bile duct: evidence for its origin in metaplastic endocrine cells. Am J Gastroenterol 86(8):1073–1076

    CAS  PubMed  Google Scholar 

  15. Chamberlain RS, Blumgart LH (1999) Carcinoid tumors of the extrahepatic bile duct. A rare cause of malignant biliary obstruction. Cancer 86(10):1959–1965

    Article  CAS  PubMed  Google Scholar 

  16. Modlin IM, Lye KD, Kidd M (2003) A 5-decade analysis of 13,715 carcinoid tumors. Cancer 97(4):934–959

    Article  PubMed  Google Scholar 

  17. Modlin IM, Shapiro MD, Kidd M (2005) An analysis of rare carcinoid tumors: clarifying these clinical conundrums. World J Surg 29(1):92–101

    Article  PubMed  Google Scholar 

  18. Hao L, Friedman AL, Navarro VJ, West B, Robert ME (1996) Carcinoid tumor of the common bile duct producing gastrin and serotonin. J Clin Gastroenterol 23(1):63–65

    Article  CAS  PubMed  Google Scholar 

  19. Felekouras E, Petrou A, Bramis K, et al. (2009) Malignant carcinoid tumor of the cystic duct: a rare cause of bile duct obstruction. Hepatobiliary Pancreat Dis Int 8(6):640–646

    PubMed  Google Scholar 

  20. Sethi H, Madanur M, Srinivasan P, et al. (2007) Non-functioning well-differentiated neuroendocrine tumor of the extrahepatic bile duct: an unusual suspect? Hepatobiliary Pancreat Dis Int 6(5):549–552

    PubMed  Google Scholar 

  21. Takahashi K, Sasaki R, Oshiro Y, et al. (2012) Well-differentiated endocrine carcinoma originating from the bile duct in association with a congenital choledochal cyst. Int Surg 97(4):315–320

    Article  PubMed Central  PubMed  Google Scholar 

  22. Tonnhofer U, Balassy C, Reck CA, Koller A, Horcher E (2009) Neuroendocrine tumor of the common hepatic duct, mimicking a choledochal cyst in a 6-year-old child. J Pediatr Surg 44(6):E23–E25

    Article  PubMed  Google Scholar 

  23. Ueyama T, Ding J, Hashimoto H, Tsuneyoshi M, Enjoji M (1992) Carcinoid tumor arising in the wall of a congenital bile duct cyst. Arch Pathol Lab Med 116(3):291–293

    CAS  PubMed  Google Scholar 

  24. Onishi I, Kitagawa H, Harada K, et al. (2013) Intraductal papillary neoplasm of the bile duct accompanying biliary mixed adenoneuroendocrine carcinoma. World J Gastroenterol 19(20):3161–3164

    Article  PubMed Central  PubMed  Google Scholar 

  25. Joo I, Lee JM (2013) Imaging bile duct tumors: pathologic concepts, classification, and early tumor detection. Abdom Imaging 38(6):1334–1350

    Article  PubMed  Google Scholar 

  26. Nikolaidis P, Hammond NA, Day K, et al. (2014) Imaging features of benign and malignant ampullary and periampullary lesions. Radiographics 34(3):624–641

    Article  PubMed  Google Scholar 

  27. Elias E, Hamlyn AN, Jain S, et al. (1976) A randomized trial of percutaneous transhepatic cholangiography with the Chiba needle versus endoscopic retrograde cholangiography for bile duct visualization in jaundice. Gastroenterology 71(3):439–443

    CAS  PubMed  Google Scholar 

  28. Okuda K, Kubo Y, Okazaki N, Arishima T, Hashimoto M (1977) Clinical aspects of intrahepatic bile duct carcinoma including hilar carcinoma: a study of 57 autopsy-proven cases. Cancer 39(1):232–246

    Article  CAS  PubMed  Google Scholar 

  29. Alexander F, Rossi RL, O’Bryan M, et al. (1984) Biliary carcinoma: A review of 109 cases. Am J Surg 147(4):503–509

    Article  CAS  PubMed  Google Scholar 

  30. Kulke MH, Benson AB 3rd, Bergsland E, et al. (2012) Neuroendocrine tumors. J Natl Compr Cancer Netw 10(6):724–764

    CAS  Google Scholar 

  31. Binderup T, Knigge U, Loft A, Federspiel B, Kjaer A (2010) 18F-fluorodeoxyglucose positron emission tomography predicts survival of patients with neuroendocrine tumors. Clin Cancer Res 16(3):978–985

    Article  CAS  PubMed  Google Scholar 

  32. Adams S, Baum R, Rink T, et al. (1998) Limited value of fluorine-18 fluorodeoxyglucose positron emission tomography for the imaging of neuroendocrine tumours. Eur J Nucl Med 25(1):79–83

    Article  CAS  PubMed  Google Scholar 

  33. Masui T, Doi R, Ito T, et al. (2010) Diagnostic value of (18)F-fluorodeoxyglucose positron emission tomography for pancreatic neuroendocrine tumors with reference to the World Health Organization classification. Oncol Lett 1(1):155–159

    PubMed Central  PubMed  Google Scholar 

  34. Kayani I, Bomanji JB, Groves A, et al. (2008) Functional imaging of neuroendocrine tumors with combined PET/CT using 68 Ga-DOTATATE (DOTA-DPhe1, Tyr3-octreotate) and 18F-FDG. Cancer 112(11):2447–2455

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, Korea

    Nurhee Hong, Hyoung Jung Kim, Jae Ho Byun, So Yeon Kim, Kyoung Won Kim & Jin Hee Kim

  2. Department of Radiology, Wonkwang University Sanbon Hospital, Gunpo, Korea

    Nurhee Hong

  3. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Seung-Mo Hong

Authors
  1. Nurhee Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hyoung Jung Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jae Ho Byun
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. So Yeon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kyoung Won Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jin Hee Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Seung-Mo Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hyoung Jung Kim.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hong, N., Kim, H.J., Byun, J.H. et al. Neuroendocrine neoplasms of the extrahepatic bile duct: radiologic and clinical characteristics. Abdom Imaging 40, 181–191 (2015). https://doi.org/10.1007/s00261-014-0191-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-014-0191-0

Keywords

Search

Navigation