A Rare Case of Incidental Common Bile Duct Adenoma-Endoscopic Ultrasound Evaluation.
An informed consent was signed by the patient for all medical procedures undertaken and publication purposes.
Benign lesions of the extra-hepatic biliary tree are very rare compared with malignancies and account for only 0.1% of biliary tract operations and 6% of all extra-hepatic bile duct masses (1). These adenomas are rare findings that are usually detected incidentally in removed gallbladders (cholelithiasis, chronic cholecystitis). However, they can occur anywhere in the extra-hepatic bile ducts with uncertain malignant potential, and there are still no guidelines for their management. A review conducted by Loh et al. (2) found that a total of 39 cases of bile tree adenomas have been reported till date. Different imaging modalities have been used for identifying these tumors with varying success rates, including contrast-enhanced ultrasound, intraductal ultrasound, and even [.sup.18]F-fluorodeoxyglucose uptake (3,4). Endoscopic therapy has rarely been reported and is considered to be relevant only in patients with high risk of surgery (5).
Extra-hepatic bile duct adenoma is a rare entity, but it should be considered in the differential diagnosis of patients with a filling defect or obstruction of bile ducts. Endoscopic ultrasound is a safe and useful diagnostic modality in these cases.
Conflict of Interest: No conflict of interest was declared by the authors.
(1.) Xu HX, Chen LD. Villous adenoma of extrahepatic bile duct: contrast enhanced sonography findings. J Clin Ultrasound 2008;36:39-41.
(2.) Loh KP, Nautsch D, Mueller J, Desilets D, Mehendiratta V. Adenomas involving the extrahepatic biliary tree are rare but have an aggressive clinical course. Endosc Int Open 2016;4:112-7.
(3.) Tefas C, Tantau M, Szenftleben A, Chiorean L, Badea R. Villous adenoma of the common hepatic duct: the importance of contrast-enhanced ultrasound and endoscopic retrograde cholangiopancreatography for relevant diagnosis. A case report and review of the literature. Med Ultrason 2015;17:553-56.
(4.) Hokonohara K, Noda T, Hatano H, Takata A, Hirota M, Oshima K, et al. Tubular adenoma of the common bile duct with uptake in 18F FDG PET: A case report. Mol Clin Oncol 2016;4:35-8.
(5.) Munshi AG, Hassan MA. Common bile duct adenoma: Case report and brief review of literature. Surg Laparosc Endosc Percutan Tech 2010;20:193-4.
Yana Valerieva (1), Ivan Lutakov (1), Branimir Golemanov (1), Georgi Jelev (2), Borislav Vladimirovl
(1) Clinical Center of Gastroenterology, University Hospital "Queen Joanna-ISUL" Sofia, Medical University Sofia, Bulgaria
(2) Clinical Center of Gastroenterology, Department of Surgery, University Hospital "Queen Joanna-ISUL" Sofia, Medical University Sofia, Bulgaria
Address for Correspondence: Dr. Yana Valerieva, Clinical Center of Gastroenterology, University Hospital "Queen Joanna-ISUL" Sofia, Bulgaria
ORCID ID: orcid.org/0000-0002-3146-5965
Received: 2November 2017
Accepted: 22March 2018
* DOI: 10.4274/balkanmedj.2017.1485
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|Author:||Valerieva, Yana; Lutakov, Ivan; Golemanov, Branimir; Jelev, Georgi; Vladimirovl, Borislav|
|Publication:||Balkan Medical Journal|
|Article Type:||Case study|
|Date:||Aug 1, 2018|
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