Gastroenterology, Dalhousie University, Halifax, Nova Scotia, Canada.
Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.
BMJ Case Rep. 2023 Nov 9;16(11):e257167. doi: 10.1136/bcr-2023-257167.
A woman in her 70s presented with painless jaundice and index biopsy of a common bile duct (CBD) mass obtained by endoscopic retrograde cholangiopancreatography was suspicious for malignant peripheral nerve sheath tumour. Treatment consisted of pancreaticoduodenectomy, and final pathology results were consistent with sarcomatoid carcinoma. Postoperative complications included pancreaticojejunal leak, surgical wound infection, bacteraemia, myocardial injury, and significant ulceration and stricturing of the oesophagus. 14 weeks post-pancreaticoduodenectomy, the patient was found to have a perforated viscus, gastroduodenal leak and diffuse small bowel ischaemia-the patient passed away following emergent laparotomy. We aim to add to the limited literature surrounding this rare CBD neoplasm.
一位 70 多岁的女性出现无痛性黄疸,经内镜逆行胰胆管造影术(ERCP)获取胆总管(CBD)肿块的索引活检,提示恶性周围神经鞘肿瘤。治疗包括胰十二指肠切除术,最终的病理结果与肉瘤样癌一致。术后并发症包括胰肠漏、手术部位感染、菌血症、心肌损伤以及食管严重溃疡和狭窄。胰十二指肠切除术后 14 周,患者发现有一个穿孔的内脏,胃十二指肠漏和弥漫性小肠缺血-在紧急剖腹手术后,患者去世。我们旨在增加有关这种罕见 CBD 肿瘤的有限文献。