Adenomyoma of the Distal Common Bile Duct Demonstrated by Endoscopic Ultrasound: A Case Report and Review of the Literature

Overview

Journal World J Clin Cases

Publisher Baishideng Publishing Group

Specialty General Medicine

Date 2019 Nov 22

PMID 31750345

Citations 3

Authors

Li-Ming Xu

Duan-Min Hu

Wen Tang

Shao-Hua Wei

Wei Chen

Guang-Qiang Chen

Affiliations

Soon will be listed here.

Abstract

Background: Adenomyomatous hyperplasia of the distal common bile duct (CBD) is very rare, with only scarce case reports in the literature. Diagnosis is usually based on imaging findings, and endoscopic biopsy is very difficult before operation. It is believed that adenomyomatous hyperplasia has little or no risk of malignant transformation.

Case Summary: A 68-year-old woman with abdominal pain in the right upper quadrant was referred to our hospital. Abdominal ultrasonography in the emergency ward revealed acute cholecystitis and dilated CBD. Laboratory findings showed elevated levels of transaminases, phosphatase, and γ-glutamyltranspeptidase. Pharmaceutical treatment for 3 d did not relieve the symptoms. Magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT) showed proximal bile duct dilatation but could not identify the cause. Endoscopic ultrasonography (EUS) demonstrated a mixed echogenic mass in the distal CBD. During surgery, a firm mass was found in the distal CBD and the Whipple procedure was performed with the initial concern of malignancy. Histology showed diffuse adenomyomatous hyperplasia.

Conclusion: EUS may be a useful choice to diagnose adenomyoma of the distal CBD before operation, especially in patients with ambiguous MRCP/CT findings.

Citing Articles

Adenomyomatosis of distal common bile duct: A case report and systemic review.

Weng C, Lee C Medicine (Baltimore). 2025; 104(9):e41649.

PMID: 40020134 PMC: 11875603. DOI: 10.1097/MD.0000000000041649.

Benign Lesion of the Common Bile Duct Mimicking a Malignant Tumor: an Entity Commonly Overdiagnosed Clinically.

Osama M, Dhawan S, Rao S, Kumar A, Rawat S Indian J Surg Oncol. 2024; 15(Suppl 2):331-337.

PMID: 38818003 PMC: 11133261. DOI: 10.1007/s13193-023-01860-3.

Bile ductal mucosal dysplasia is a possible risk factor for adenocarcinoma in patients with adenomyomatous hyperplasia of the Vaterian system: a single-centre study from China.

Liu W, Li J, Yang Z, Jiang J, Zhang D, Lu W BMC Gastroenterol. 2024; 24(1):8.

PMID: 38166823 PMC: 10759493. DOI: 10.1186/s12876-023-03096-5.

Adenomyomatous hyperplasia of the extrahepatic bile duct: a systematic review of a rare lesion mimicking bile duct carcinoma.

Sugimachi K, Mano Y, Matsumoto Y, Iguchi T, Taguchi K, Hisano T Clin J Gastroenterol. 2021; 14(2):393-401.

PMID: 33400191 DOI: 10.1007/s12328-020-01327-w.

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