Koh Dong Wook, Lee Woo Jin, Kim Ji Hoon, Choi Jun-Il, Kim Seong Hoon, Hong Eun Kyung, Park Joong-Won, Kim Chang-Min
Center for Liver Cancer, National Cancer Center, Goyang, Korea.
Korean J Gastroenterol. 2008 Jul;52(1):32-6.
Amputation neuroma or traumatic neuroma is a tumor-like secondary hyperplasia that may develop after an accidental or surgical trauma. Amputation neuroma of the bile duct has occasionally been reported which occurred in the cystic duct stump late after the cholecystectomy. However, even if the amputation neuroma is suspected in a patient with late-onset jaundice after cholecystectomy, the differential diagnosis from a malignancy is difficult preoperatively. We experienced a case of the amputation neuroma of common bile duct (CBD) developed in a 70-year-old man who presented with a polypoid mass in CBD. He had undergone cholecystectomy 25 years ago and choledochojejunostomy 12 years ago, respectively. We have performed pylorus-preserving pancreatico-duodenectomy (PPPD) under the impression of CBD cancer. He had not been diagnosed of amputation neuroma until having undergone PPPD. We report a case of CBD neuroma mimicking CBD cancer, which was confirmed after PPPD.
截肢性神经瘤或创伤性神经瘤是一种肿瘤样继发性增生,可在意外或手术创伤后发生。胆管截肢性神经瘤偶尔有报道,发生于胆囊切除术后晚期的胆囊管残端。然而,即使在胆囊切除术后出现迟发性黄疸的患者中怀疑有截肢性神经瘤,术前与恶性肿瘤的鉴别诊断也很困难。我们遇到一例70岁男性发生胆总管截肢性神经瘤,该患者胆总管内有一个息肉样肿物。他分别于25年前接受了胆囊切除术,12年前接受了胆总管空肠吻合术。我们在诊断为胆总管癌的情况下实施了保留幽门的胰十二指肠切除术(PPPD)。直到接受PPPD后他才被诊断为截肢性神经瘤。我们报告一例模仿胆总管癌的胆总管神经瘤病例,该病例在PPPD后得到确诊。