Čekas Karolis, Rudaitis Vilius, Beiša Virgilijus, Jotautas Valdemaras, Rutkauskaitė Dileta, Meškauskas Raimundas, Stratilatovas Eugenijus
Faculty of Medicine, Vilnius University, M. K. Čiurlionio Street 21, 03101, Vilnius, Lithuania.
Clinic of Internal Diseases, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, Department of Gynecology, Center of Women's Physiology and Pathology, Vilnius University Hospital Santariškių Klinikos, Santariškių Street 2, 08661, Vilnius, Lithuania.
J Med Case Rep. 2016 Jan 21;10:18. doi: 10.1186/s13256-015-0789-z.
According to the literature, benign bile duct tumors are exceedingly uncommon. To the best of our knowledge, we report the largest extrahepatic bile duct villous adenoma described in the literature.
We present a case of a 77-year-old Caucasian woman with obstructive jaundice. Laboratory tests revealed that she had elevated bilirubin and liver enzyme levels. A computed tomographic scan showed a homogeneous 5 × 3-cm mass obstructing the common bile duct. The results of brush cytology were consistent with a bile duct villous papilloma. However, on the basis of the tumor's radiological features, a preliminary diagnosis of extrahepatic bile duct malignant tumor was made. After discussion among the multidisciplinary team, a surgical resection of the bile duct tumor was performed. Histopathological examination confirmed a villous adenoma. The patient's postoperative course was uneventful.
In patients with bulky extrahepatic bile duct tumors, surgical resection alone may be safe and curative.
根据文献记载，良性胆管肿瘤极为罕见。据我们所知，我们报告了文献中描述的最大的肝外胆管绒毛状腺瘤。
我们报告一例77岁的白种女性，患有梗阻性黄疸。实验室检查显示她的胆红素和肝酶水平升高。计算机断层扫描显示一个5×3厘米的均匀肿块阻塞胆总管。刷检细胞学结果与胆管绒毛状乳头状瘤一致。然而，根据肿瘤的影像学特征，初步诊断为肝外胆管恶性肿瘤。多学科团队讨论后，对胆管肿瘤进行了手术切除。组织病理学检查证实为绒毛状腺瘤。患者术后恢复顺利。
对于肝外胆管巨大肿瘤患者，单纯手术切除可能是安全且可治愈的。
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