Published online Nov 7, 2014. doi: 10.3748/wjg.v20.i41.15448
Revised: May 7, 2014
Accepted: August 13, 2014
Published online: November 7, 2014
Primary giant-cell tumors rarely arise in the common bile duct. We herein report a case of primary giant-cell tumor of the common bile duct. The patient was an 81-year-old male who was diagnosed with a well-defined 1.2-cm mass projecting into the lumen of the middle common bile duct. Excision of the gallbladder and extrahepatic bile duct and a Roux-en-Y cholangiojejunostomy were performed. Histologically, the tumor had no association with carcinomas of epithelial origin and was similar to giant-cell tumors of the bone. The tumor consisted of a mixture of mononuclear and multinucleated osteoclast-like giant cells. The mononuclear cells showed no atypical features, and their nuclei were similar to those of the multinucleated giant cells. CD68 was expressed on the mononuclear and multinucleated osteoclast-like giant cells, whereas CD163 immunoreactivity was restricted to the mononuclear cells. Six months after the operation, the patient was still alive and had no recurrence. The interest of this case lies in the rarity of this entity, the difficulty of preoperative diagnosis, and this tumor’s possible confusion with other malignant tumors.
Core tip: In visceral organs, different types of carcinomas, such as anaplastic spindle- and giant-cell carcinomas of the gallbladder and extrahepatic bile duct, may contain a variable number of osteoclast-like giant cells. It is crucial to separate those carcinomas with osteoclast-like giant cells from giant-cell tumors because of their striking differences in prognosis. This case report represents the fifth case of a primary giant-cell tumor of the common bile duct in the English-language literature. We also review several reported cases to summarize clinical information about this rare tumor.