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Erschienen in:
21.11.2018 | GI Image
Extrahepatic Neuroendocrine Tumor Causing Biliary Obstruction
Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 6/2019
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A 57-year-old man with a past medical history of hyperlipidemia and gastroesophageal reflux disease presented for surgical consultation after a comprehensive work up for abdominal pain. He reported vague abdominal discomfort and a sensation of bloating but no other symptoms. He denied a history of jaundice, liver disease, or malignancy and had no prior abdominal operations. Physical examination revealed a well-nourished, healthy-appearing middle-aged man with no abdominal distention or tenderness, no palpable lymphadenopathy, and no jaundice. Hepatic function panel as well as the tumor markers CEA, CA19-9, and AFP was normal. Computed tomography revealed significant right intrahepatic ductal dilatation and a 1-cm hilar mass associated with the right hepatic duct (Fig. 1). An attempted endoscopic retrograde cholangiopancreatography to obtain a tissue biopsy had failed because of a technical inability to cannulate the ampulla, and endoscopic ultrasound failed to reveal a mass.
Fig. 1
Axial (a) and coronal (b) computed tomographic images demonstrate a well-circumscribed 1-cm mass at the hepatic ductal confluence denoted by the arrow
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