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以慢性上腹部疼痛为表现的胆囊神经纤维瘤——病例报告及文献综述

Gallbladder neurofibroma presenting as chronic epigastric pain - Case report and review of the literature.

作者信息

Sucandy Iswanto, Sharma Devesh, Dalencourt Gregory, Bertsch David J

机构信息

Department of Surgery, Abington Memorial Hospital, Abington, Pennsylvania, USA.

出版信息

N Am J Med Sci. 2010 Oct;2(10):496-8. doi: 10.4297/najms.2010.2496.

Abstract

CONTEXT

Benign nonepithelial neoplasms of the gallbladder are unusual. The majority of gallbladder neurofibromas are found incidentally in the gallbladder specimens following cholecystectomy. There have been only few reports in the literature describing this rare entity. In this study we report a case of gallbladder neurofibroma presenting as chronic epigastric pain in a young patient.

CASE REPORT

A thirty two year old otherwise healthy man presented to our clinic with chronic epigastric pain symptom after eating. Physical examination, laboratory and radiologic workups were unremarkable for signs of biliary tract diseases. Past medical and surgical histories were significant only for neurofibromatosis type I. Due to persistent symptomatology, the patient was taken to the operating room for a diagnostic laparoscopy followed by laparoscopic cholecystectomy. Open conversion was necessitated because of the presence of a gallbladder mass preventing safe anatomic dissection. Surgical pathology revealed plexiform neurofibroma with noninflamed gallbladder. The postoperative course was unremarkable and the patient was pain free at 3 weeks postoperatively.

CONCLUSIONS

Benign neoplasms such as gallbladder neurofibroma should be included in the differential diagnosis for chronic epigastric pain symptom in a young otherwise healthy patient with neurofibromatosis. Diagnostic laparoscopy should be considered in an individual presenting with this condition.

摘要

背景

胆囊良性非上皮性肿瘤并不常见。大多数胆囊神经纤维瘤是在胆囊切除术后的胆囊标本中偶然发现的。文献中仅有少数报道描述了这种罕见的实体。在本研究中,我们报告了一例年轻患者中表现为慢性上腹部疼痛的胆囊神经纤维瘤病例。

病例报告

一名32岁的健康男性因进食后出现慢性上腹部疼痛症状前来我院就诊。体格检查、实验室检查和影像学检查均未发现胆道疾病的迹象。既往病史和手术史仅因患有I型神经纤维瘤病而有意义。由于症状持续存在,患者被送往手术室进行诊断性腹腔镜检查,随后进行腹腔镜胆囊切除术。由于存在胆囊肿块,无法进行安全的解剖分离,因此需要转为开放手术。手术病理显示为丛状神经纤维瘤伴胆囊无炎症。术后病程顺利,患者术后3周时疼痛消失。

结论

对于患有神经纤维瘤病的年轻健康患者出现慢性上腹部疼痛症状时,应将胆囊神经纤维瘤等良性肿瘤纳入鉴别诊断。对于出现这种情况的个体,应考虑进行诊断性腹腔镜检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81fb/3339114/83fb3fbb98ea/NAJMS-2-496-g001.jpg

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