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A Case Report of the Rarely Identified Malignant Peripheral Nerve Sheath Tumor of the Common Bile Duct: 2017 Presidential Poster Award

2017; Lippincott Williams & Wilkins; Volume: 112; Linguagem: Inglês

10.14309/00000434-201710001-01303

1572-0241

Justine Fenner, Michael P. Croglio, Demetrios Tzimas, Juan Carlos Bucobo,

Gastrointestinal Tumor Research and Treatment

Primary malignant peripheral nerve sheath tumors (MPNSTs) of the common bile duct are extraordinarily rare. Thorough review of the literature revealed only one published report in 2005 describing a 58-year-old female with MPNST of the common bile duct that was completely resected. In this paper, we present the case of a 77-year-old male with MPNST of the common bile duct. The patient presented with jaundice and fatigue. Right upper quadrant ultrasound revealed mild hepatomegaly as well as extrahepatic and intrahepatic ductal dilation. Computerized tomography of the abdomen revealed a hyperdense mass extending into the left lobe of the liver. Common bile duct biopsies and cytology revealed high-grade spindle cell sarcoma, most consistent with malignant peripheral nerve sheath tumor.Figure: Computed tomography image demonstrating biliary ductal dilation just above the internal bile duct stent, extending into the liver. A hyperdensity is seen just superior to the stent representing the malignancy.Figure: Direct cholangioscope view of tumor in the common bile duct.Figure: Poorly differentiated hyperchromatic tumor cells, with mitotic figures.