Department of Gastrointestinal Surgery, Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India
Department of Pathology, Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India.
BMJ Case Rep. 2021 Jun 28;14(6):e241712. doi: 10.1136/bcr-2021-241712.
A 31-year-old woman, presenting with right upper quadrant pain, was suspected to have malignant gall bladder polyp based on MRI and CT scan findings. She underwent radical cholecystectomy with excision of bile duct and hepaticojejunostomy. Surprisingly, histology revealed parasitic remnants within the bile duct wall with no evidence of malignancy. A year later, this young woman suffers significant impairment of quality of life, perhaps an aftermath to the radicality of the surgery. Our case demonstrates a masquerade of 'malignant biliary polyp' by a parasite. This raises the need for extensive investigations such as endoscopic ultrasound guided biopsies, parasitic serology and positron emission tomography (PET) scans when patients present with probable malignant biliary lesions, even in difficult-to-access areas. A preoperative diagnosis might have averted an unnecessary major surgery in this young woman.
一位 31 岁女性因右上腹疼痛就诊，MRI 和 CT 扫描结果提示可能患有恶性胆囊息肉。她接受了根治性胆囊切除术，包括胆管切除和胆肠吻合术。令人惊讶的是，组织学检查显示胆管壁内有寄生虫残留，无恶性证据。一年后，这位年轻女性的生活质量显著受损，这可能是手术根治性的后果。我们的病例展示了寄生虫伪装成“恶性胆道息肉”。这就需要进行广泛的检查，如内镜超声引导下活检、寄生虫血清学和正电子发射断层扫描（PET）扫描，当患者出现可能的恶性胆道病变时，即使在难以到达的区域也是如此。术前诊断可能避免了这位年轻女性进行不必要的大手术。
