Case Report
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World J Gastroenterol. Oct 7, 2012; 18(37): 5305-5308
Published online Oct 7, 2012. doi: 10.3748/wjg.v18.i37.5305
Biliary tract schwannoma: A rare cause of obstructive jaundice in a young patient
Gilton Marques Fonseca, André Luis Montagnini, Manoel de Souza Rocha, Rosely Antunes Patzina, Mário Vinícius Angelete Alvarez Bernardes, Ivan Cecconello, José Jukemura
Gilton Marques Fonseca, André Luis Montagnini, Manoel de Souza Rocha, Rosely Antunes Patzina, Mário Vinícius Angelete Alvarez Bernardes, Ivan Cecconello, José Jukemura, Digestive Surgery Division, Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, SP 05403-900, Brazil
Author contributions: Fonseca GM and Jukemura J designed research; Fonseca GM and Bernardes MVAA performed research; Montagnini AL, Rocha MS, Patzina RA, Cecconello I and Jukemura J analyzed and reviewed the paper; and Fonseca GM and Jukemura J wrote the paper.
Correspondence to: Gilton Marques Fonseca, MD, Digestive Surgery Division, Department of Gastroenterology, School of Medicine, University of São Paulo, Avenida Doutor Enéas de Carvalho Aguiar, Avenida de Carvalho Aguiar Enéas Doutor, 255 Central Institute, Room 9074, São Paulo, SP 05403-900, Brazil. medgilton@yahoo.com.br
Telephone: +55-11-26617560 Fax: +55-11-26617560
Received: March 12, 2012
Revised: July 26, 2012
Accepted: July 28, 2012
Published online: October 7, 2012
Abstract

Schwannoma is a tumor derived from Schwann cells which usually arises in the upper extremities, trunk, head and neck, retroperitoneum, mediastinum, pelvis, and peritoneum. However, it can arise in the gastrointestinal tract, including biliary tract. We present a 24-year-old male patient with obstructive jaundice, whose investigation with computed tomography abdomen showed focal wall thickening in the common hepatic duct, difficult to differentiate with hilar adenocarcinoma. He was diagnosed intraoperatively schwannoma of common bile duct and treated with local resection. The patient recovered well without signs of recurrence of the lesion after 12 mo. We also reviewed the common bile duct schwannoma related in the literature and evaluated the difficulty in pre and intraoperative differential diagnosis with adenocarcinoma hilar. Resection is the treatment of choice for such cases and the tumor did not recur in any of the resected cases.

Keywords: Schwannoma; Neurilemoma; Biliary tract; Hilar adenocarcinoma; Computadorized tomography