scholarly journals Non-functioning neuroendocrine tumors of the common hepatic duct: a case report and literature review

2017 ◽  
Vol 4 (3) ◽  
pp. 1101
Author(s):  
Maroun Abou-Jaoude ◽  
Haydar A. Nasser
Keyword(s):  
Neuroendocrine Tumors ◽  
Epigastric Pain ◽  
Hepatic Duct ◽  
Young Patients ◽  
Pancreatic Head ◽  
Long Term Results ◽  
Common Hepatic Duct ◽  
The Common ◽  
Well Differentiated

Extra-hepatic biliary tree neuroendocrine tumors are not common, accounting for about 0.1 % of all carcinoid tumors. Those affecting the common hepatic duct are very rare and their diagnosis is usually made post-operatively. Poorly differentiated tumors or neuroendocrine carcinomas are commonly seen in elderly, whereas well differentiated tumors, tend to occur in young patients, for whom surgery will lead to good long term results. About 100 cases have been reported in the English medical literature, showing good long term results after surgery for well differentiated (Grades 1 and 2) tumors. Herein, we report a case of an 18-year-old female, complaining from a dull epigastric pain related to a nodule compressing the common hepatic duct. After complete investigation, a laparotomy has been performed and showed a nodular tumor located in the common hepatic duct just above the insertion of the cystic duct with close contact with the pancreatic head distally. En bloc cholecystectomy with bile duct resection was performed and followed by a Roux-en-Y hepatico-jejunostomy. The pathology of the nodule came back to be a neuroendocrine tumor grade 2.

Heterotopic Gastric Mucosa in a Duplication Cyst of the Common Hepatic Duct Mimicking Cholangiocarcinoma

2017 ◽  
Vol 26 (1) ◽  
pp. 84-88 ◽  
Author(s):  
Amedeo Sciarra ◽  
Roxane Hessler ◽  
Sébastien Godat ◽  
Montserrat Fraga ◽  
Clarisse Dromain ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Biliary Tract ◽  
Hepatic Duct ◽  
Late Complication ◽  
Young Patients ◽  
Duplication Cyst ◽  
Heterotopic Gastric Mucosa ◽  
Common Hepatic Duct ◽  
Advanced Fibrosis ◽  
The Common

Heterotopic gastric mucosa in biliary tract is a congenital anomaly that can prove significant clinical dilemmas. Here we report the case of a 28-year-old female patient presenting with jaundice, pruritus, and altered liver tests, with predominant cholestasis. Liver biopsy revealed histological changes suggesting large bile duct obstruction with advanced fibrosis. At imaging, common hepatic duct stricture due to an intraluminal enhancing mass was observed. Endoscopic retrograde cholangiopancreatography and upper echoendoscopy revealed a firm mass of the common hepatic duct with a complete obstruction, suspicious for cholangiocarcinoma. Fine-needle aspiration biopsy performed under echoendoscopic guidance revealed fundic type gastric mucosa. Despite histological result, radiological suspicion of malignancy together with advanced fibrosis prompted a segmental resection of biliary tract. At macroscopic examination, the common hepatic duct presented a focal pseudocystic appearance with a firm zone of subtotal stenosis. Histology revealed a duplication cyst lined by heterotopic fundic gastric mucosa. Heterotopic gastric mucosa of the biliary tract should be suspected in young patients without know risk factors for hepatobiliary malignancies. Imaging and careful histological examination are mandatory for optimal management. Liver fibrosis, secondary to chronic biliary obstruction may be a significant late complication.

scholarly journals Long Term Survival in a Patient Following Resection for Carcinoma of the Gallbladder and Rectum

HPB Surgery ◽  
1993 ◽  
Vol 7 (2) ◽  
pp. 165-174
Author(s):  
S. B. Kelly ◽  
N. A. Habib ◽  
L. H. Blumgart
Keyword(s):  
Case Report ◽  
Hepatic Duct ◽  
Early Carcinoma ◽  
Common Hepatic Duct ◽  
Term Survival ◽  
Carcinoma Of The Rectum ◽  
Gallbladder Mucosa ◽  
Carcinoma Of The Gallbladder ◽  
The Common

We describe a 66-year-old man who presented initially with acute cholecystitis. He was treated by cholecystostomy and biopsy of the gallbladder mucosa which revealed carcinoma of the gallbladder. Four weeks later a cholecystectomy was performed followed by resection of the common bile duct, common hepatic duct and segments IV and V of the liver and a hepaticojejunostomy. Sixteen months later an abdomino-perineal resection was performed for a moderately differentiated Dukes′ stage C carcinoma of the rectum. He is alive and without evidence of recurrence seven years later. Few patients survive for this length of time following resection of either carcinoma of the gallbladder or rectum. This case report demonstrates the value of aggressive surgical treatment in patients with early carcinoma of the gallbladder.

NEUROENDOCRINE TUMORS OF THE PANCREAS: ETIOLOGY, PATHOGENESIS, DIAGNOSIS, AND CURRENT TREATMENT APPROACHES

2018 ◽  
Vol 64 (6) ◽  
pp. 830-839
Author(s):  
Temuri Morgoshiya
Keyword(s):  
Neuroendocrine Tumors ◽  
Clinical Manifestations ◽  
Gastrointestinal Hormones ◽  
Current Treatment ◽  
High Potential ◽  
Long Term Results ◽  
Considerable Part ◽  
Treatment Approaches ◽  
By Products

The overview of literature on modem classification issues, diagnostics and treatments of neuroendocrinal tumors of a pancreas is provided. According to modern views all neuroendocrinal tumors of a pancreas having clinical manifestations (in the form of the syndromes caused by products of specific hormones; increases in level of hormones in blood of patients without clinical manifestations; in the form of signs of existence of volume education in various departments of PZh) and/or the researches (more than 5 mm) revealed by means of beam methods are malignant in the biology as they have high potential to innidiation. In article it is shown that a considerable part of neuroendocrinal tumors of a pancreas are nonfunctioning, i.e. not cosecreting various gastrointestinal hormones and polypeptides in blood and thereof not followed characteristic clinical manifestations. It is noted that diagnostics of neuroendocrinal tumors of a pancreas is extremely difficult task on which solution the choice of a method of treatment and its long-term results depends...

scholarly journals Molecular Pathology of Well-Differentiated Pulmonary and Thymic Neuroendocrine Tumors: What Do Pathologists Need to Know?

2021 ◽  
Vol 32 (1) ◽  
pp. 154-168 ◽  
Author(s):  
Marco Volante ◽  
Ozgur Mete ◽  
Giuseppe Pelosi ◽  
Anja C. Roden ◽  
Ernst Jan M. Speel ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Young Patients ◽  
Carcinoid Tumors ◽  
Neuroendocrine Neoplasms ◽  
Grey Zone ◽  
Cell Hyperplasia ◽  
Ki 67 ◽  
Familial Form ◽  
Well Differentiated ◽  
Neuroendocrine Carcinomas

AbstractThoracic (pulmonary and thymic) neuroendocrine tumors are well-differentiated epithelial neuroendocrine neoplasms that are classified into typical and atypical carcinoid tumors based on mitotic index cut offs and presence or absence of necrosis. This classification scheme is of great prognostic value but designed for surgical specimens, only. Deep molecular characterization of thoracic neuroendocrine tumors highlighted their difference with neuroendocrine carcinomas. Neuroendocrine tumors of the lung are characterized by a low mutational burden, and a high prevalence of mutations in chromatin remodeling and histone modification-related genes, whereas mutations in genes frequently altered in neuroendocrine carcinomas are rare. Molecular profiling divided thymic neuroendocrine tumors into three clusters with distinct clinical outcomes and characterized by a different average of copy number instability. Moreover, integrated histopathological, molecular and clinical evidence supports the existence of a grey zone category between neuroendocrine tumors (carcinoid tumors) and neuroendocrine carcinomas. Indeed, cases with well differentiated morphology but mitotic/Ki-67 indexes close to neuroendocrine carcinomas have been increasingly recognized. These are characterized by specific molecular profiles and have an aggressive clinical behavior. Finally, thoracic neuroendocrine tumors may arise in the background of genetic susceptibility, being MEN1 syndrome the well-defined familial form. However, pathologists should be aware of rarer germline variants that are associated with the concurrence of neuroendocrine tumors of the lung or their precursors (such as DIPNECH) with other neoplasms, including but not limited to breast carcinomas. Therefore, genetic counseling for all young patients with thoracic neuroendocrine neoplasia and/or any patient with pathological evidence of neuroendocrine cell hyperplasia-to-neoplasia progression sequence or multifocal disease should be considered.

scholarly journals Anatomic Variations of the Right Hepatic Duct: Results and Surgical Implications from a Cadaveric Study

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Theodoros Mariolis-Sapsakos ◽  
Vasileios Kalles ◽  
Konstantinos Papatheodorou ◽  
Nikolaos Goutas ◽  
Ioannis Papapanagiotou ◽  
...  
Keyword(s):  
Bile Ducts ◽  
Hepatic Duct ◽  
Anatomical Variations ◽  
Common Hepatic Duct ◽  
Drainage Pattern ◽  
Left Hepatic Duct ◽  
Surgical Interventions ◽  
Drainage Patterns ◽  
The Common ◽  
The Right

Purpose. Thorough understanding of biliary anatomy is required when performing surgical interventions in the hepatobiliary system. This study describes the anatomical variations of right bile ducts in terms of branching and drainage patterns, and determines their frequency. Methods. We studied 73 samples of cadaveric material, focusing on the relationship of the right anterior and posterior segmental branches, the way they form the right hepatic duct, and the main variations of their drainage pattern. Results. The anatomy of the right hepatic duct was typical in 65.75% of samples. Ectopic drainage of the right anterior duct into the common hepatic duct was found in 15.07% and triple confluence in 9.59%. Ectopic drainage of the right posterior duct into the common hepatic duct was discovered in 2.74% and ectopic drainage of the right posterior duct into the left hepatic duct in 4.11%. Ectopic drainage of the right anterior duct into the left hepatic ductal system and ectopic drainage of the right posterior duct into the cystic duct was found in 1.37%. Conclusion. The branching pattern of the right hepatic duct was atypical in 34.25% of cases. Thus, knowledge of the anatomical variations of the extrahepatic bile ducts is important in many surgical cases.

scholarly journals A rare cause of biliary obstruction – intraductal neuroendocrine tumor of the right hepatic biliary duct: a case report

2020 ◽  
Author(s):  
Mirela Danila ◽  
Roxana Sirli ◽  
Alina Popescu ◽  
Nicoleta Iacob ◽  
Ana-Maria Ghiuchici
Keyword(s):  
Neuroendocrine Tumors ◽  
Biliary Obstruction ◽  
Ultrasound Examination ◽  
Hepatic Duct ◽  
Biliary Duct ◽  
Presumptive Diagnosis ◽  
Additional Imaging ◽  
Biliary Ducts ◽  
Well Differentiated ◽  
The Right

Primary biliary tract neuroendocrine tumors (NETs) are extremely rare tumors that account for 0.2-2% of all gastrointestinal neuroendocrine tumors. The typical presentation is with jaundice and other symptoms related to biliary obstruction.We present a case of right hepatic duct NET in a 27-year-old female patient, asymptomatic, presented for a routine ultrasound examination that revealed moderate dilatation of the intrahepatic biliary ducts and a 20 mm hyperechoic lesion in the right hepatic biliary duct. Additional imaging was performed with the presumptive diagnosis of cholangiocarcinoma. After surgery, the histopathological and immunohistochemical report was conclusive for the diagnosis of G2 well-differentiated NET

scholarly journals Why carotid endarterectomy is method of choice in treatment of carotid stenosis

2008 ◽  
Vol 136 (3-4) ◽  
pp. 181-186 ◽  
Author(s):  
Djordje Radak ◽  
Lazar Davidovic
Keyword(s):  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Stent Implantation ◽  
Radical Neck Dissection ◽  
Carotid Stenting ◽  
Long Term Results ◽  
Radiation Induced ◽  
The Common ◽  
Graft Interposition

Procedures used in treatment of carotid stenosis are endarterectomy, PTA with stent implantation, resection with graft interposition and by-pass procedure. Segmental lesions are found more often and treated by the first two mentioned procedures. In case of longer lesions and extension to the greater part of the common carotid artery, the other two procedures are performed. For the past few years, the main dilemma has been whether to perform carotid endarterectomy or PTA with stent implantation. Both early and long-term results speak in favour of carotid endarterectomy, regardless of an increased number of PTA and carotid stenting. At the same time, PTA and carotid stenting are more expensive procedures. Both methods have their defined and important roles in treatment of segmental occlusive carotid lesions. Severe cardiac, pulmonary and renal conditions, which increase the risk of general anaesthesia, are not an absolute indication for PTA and stenting, since endarterectomy can be done in regional anaesthesia. Main indications for PTA with stent implantation are: surgically inaccessible lesions (at or above C2; or subclavian); radiation- induced carotid stenosis; prior ipsilateral radical neck dissection; prior carotid endarterectomy (restenosis).

Measurement of capacity of biliary tree in rats

1963 ◽  
Vol 205 (6) ◽  
pp. 1122-1126 ◽  
Author(s):  
G. Barber-Riley
Keyword(s):  
Hepatic Duct ◽  
Biliary Tree ◽  
Liver Weight ◽  
Common Hepatic Duct ◽  
Marker Substances ◽  
The Common ◽  
Made In

A method is described for measuring the capacity of the normal and of the distended biliary tree. The method depends on the use of dyes rapidly excreted in the bile, which are used as marker substances, and is here applied to rats. The use of an alternative suitable dye, or large alterations in the quantity injected, produced in most cases only small changes in the measured capacities. The measured capacity of both the normal and of the distended biliary tree was found to be proportional to the liver weight, and was altered by an expected amount when a lobe of the liver was functionally removed. The measured extra capacity produced by obstruction of the common hepatic duct was similar to that found using another method. The reliability of the method and some probable errors are briefly discussed. It is concluded that measurements made in this manner might be used to examine the biliary tree during short periods of obstruction.

Endometrial clear cell carcinoma with metastasis to the common hepatic duct: A rare aetiology of obstructive jaundice, diagnosed by biliary cytology brushing specimen

Cytopathology ◽  
2020 ◽  
Vol 31 (3) ◽  
pp. 240-242
Author(s):  
Beena U. Ahsan ◽  
Mohamed Alhamar ◽  
Kathryn M. Hogan ◽  
Daniel Schultz ◽  
Tobias Zuchelli ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Hepatic Duct ◽  
Common Hepatic Duct ◽  
The Common ◽  
Biliary Cytology

scholarly journals Reconstruction of finger joints using autologous rib perichondrium – an observational study at a single Centre with a median follow-up of 37 years

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Muder ◽  
Ola Nilsson ◽  
Torbjörn Vedung
Keyword(s):  
Range Of Motion ◽  
Young Patients ◽  
Long Term Results ◽  
Dash Score ◽  
Finger Joints ◽  
Joint Reconstruction ◽  
Additional Surgery ◽  
Contralateral Hand ◽  
The Mean

Abstract Background Gratifying long-term results are difficult to achieve when reconstructing osteoarthritic finger joints. Implant surgery is the most commonly used method to restore function and dexterity. However, all types of implant have disadvantages and may be a less favorable option in some cases, especially in young patients with a long expected lifetime and high demands on manual load. Implant related complications as loosening, instability, subsidence and stiffness are the main concerns. In this context, joint reconstruction using rib perichondrium might be a reasonable alternative in selected cases. The aim of the study was to evaluate the long-term results of finger joint reconstruction using rib perichondrial transplantation. Methods The study group (n = 11) consisted of eight individuals reconstructed in the proximal interphalangeal (PIP) joints and three reconstructed in the metacarpophalangeal (MCP) joints during 1974–1981. All patients were evaluated at clinical visits (median: 37 years after perichondrial transplantation, range: 34–41 years) using radiographs, disability in arm-shoulder-hand (DASH) score, Visual Analog Scale (VAS), range-of-motion (ROM) and manual strength (JAMAR). Results None of the 11 patients had undergone additional surgery. All of the PIP-joints (n = 8) were almost pain-free at activity (VAS 0,6) (range 0–4), had an average range-of-motion of 41 degrees (range 5–80) and a mean DASH-score of 8,3 (range 1–51). The mean strength was 41 kg compared to 44 kg in the contralateral hand (93%). The three MCP joints were almost pain-free at activity (VAS 0,7), (range 0–1). The ROM was on average 80 degrees (range 70–90) and the mean DASH-score was 2 (range 1–3). The mean strength was 43 kg compared to 53 kg in the contralateral hand (81%). Conclusions Perichondrium transplants restored injured PIP and MCP joints that remained essentially pain-free and mostly well-functioning without need for additional surgeries up to 41 years after the procedure. Additional studies are needed to evaluate long-term results in comparison to modern implants and to better describe the factors that determine the outcome of these procedures. Level of evidence Level IV, Therapeutic Study.

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