Traumatic Biliary Neuroma Mimicking a Malignant Tumor. Case Report

Abstract

Case presentation. A 53-year-old woman presented abdominal pain, weight loss, fever, choluria, and conjunctival jaundice. During the physical examination, the eyes were observed with icteric staining 3+/4+, and the abdomen had abundant adipose panniculus without signs of peritoneal irritation. Patient with history of a laparoscopic cholecystectomy 12 year ago. Treatment. An endoscopic retrograde cholangiopancreatography was performed, which showed an impassable critical stenosis in the main biliary tract. Computed tomography showed dilatation of the intrahepatic bile duct. Blood tests showed a cholestatic pattern with elevation of the tumor marker CA19-9. At a multidisciplinary conference, it was decided to opt for a surgical approach, and a resection of the extrahepatic bile duct with lymph node dissection and reconstruction with the Abdo-Machado technique was performed. The pathological report was compatible with a traumatic neuroma of the biliary tract. Outcome. She presented a Clavien-Dindo IVa type complication, was treated in the Critical Care Unit with favorable evolution, resolving the complication, and was discharged in stable condition from the General Surgery Service. At six months postoperatively, she has not presented any incident.