Abstract
Extrahepatic bile ducts (EHBD) remain one of the rarest primary sites for neuroendocrine tumors (NETs) accounting for 0.1 % to 0.2 % of all NETs of the gastrointestinal tract. We present one such case, a 28-year-old female with vague abdominal symptoms and periportal lymph node enlargement on radiological examination. Endoscopic retrograde cholangiopancreaticography revealed 1.5 cms long common hepatic duct stricture and brush cytology showed no malignant cells. Endoscopic ultrasound guided fine needle aspiration cytology from the lymph nodes reported malignant cells. Roux-en-Y hepaticojejunostomy with excision of the extrahepatic biliary tree and radical lymphadenectomy was done. The diagnosis of well-differentiated neuroendocrine carcinoma was confirmed on histological and immunohistochemical studies. NETs of biliary tract are difficult to diagnose preoperatively. The aggressive use of curative and cytoreductive surgery is the frontline of treatment. But the rare alternative diagnosis of NETs should be kept in mind by the surgeon for proper timely management.
References
Langley K. The neuroendocrine concept today. Ann N Y Acad Sci. 1994;15:1–17.
Eriksson B, Oberg K. Carcinoid syndrome. In: DeGroot LJ, Jameson JL, eds. Endocrinology. 5th ed. Philadelphia: Elsevier Saunders; 2006. pp. 3571–84.
Are C, Gonen M, D’Angelica M, et al. Differential diagnosis of proximal biliary obstruction. Surgery. 2006;140:756–63.
Felekouras E, Petrou A, Bramis K, et al. Malignant carcinoid tumor of the cystic duct: a rare cause of bile duct obstruction. Hepatobiliary Pancreat Dis Int. 2009;8:640–6.
Sethi H, Madanur M, Srinivasan P, Portmann B, Heaton N, Rela M. Non-functioning well-differentiated neuroendocrine tumor of the extrahepatic bile duct: an unusual suspect? Hepatobiliary Pancreat Dis Int. 2007;6:549–52.
Davies A. Carcinoid tumor (argentaffinomata). Ann R Coll Engl. 1959;25:277–80.
Hubalewska-Dydejczyk A, Trofimiuk M, Sowa-Staszczak A, et al. Neuroendocrine tumours of rare location. Endokrynol Pol. 2010;61:322–7.
Turaga KK, Kvols LK. Recent progress in the understanding, diagnosis, and treatment of gastroenteropancreatic neuroendocrine tumors. CA Cancer J Clin. 2011;61:113–32.
Ferrone CR, Tang LH, D’Angelica M, et al. Extrahepatic bile duct carcinoid tumors: malignant biliary obstruction with a good prognosis. J Am Coll Surg. 2007;205:357–61.
Chamberlain RS, Blumgart LH. Carcinoid tumors of the extrahepatic bile duct. A rare cause of malignant biliary obstruction. Cancer. 1999;86:1959–65.
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Bhalla, P., Powle, V., Shah, R.C. et al. Neuroendocrine tumor of common hepatic duct. Indian J Gastroenterol 31, 144–146 (2012). https://doi.org/10.1007/s12664-012-0197-x
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DOI: https://doi.org/10.1007/s12664-012-0197-x