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

Details

Serval ID
serval:BIB_0171DFAFBED0
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Heterotopic Gastric Mucosa in a Duplication Cyst of the Common Hepatic Duct Mimicking Cholangiocarcinoma.
Journal
International journal of surgical pathology
Author(s)
Sciarra A., Hessler R., Godat S., Fraga M., Dromain C., Duran R., Halkic N., Sempoux C.
ISSN
1940-2465 (Electronic)
ISSN-L
1066-8969
Publication state
Published
Issued date
02/2018
Peer-reviewed
Oui
Volume
26
Number
1
Pages
84-88
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
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.

Keywords
cholangiocarcinoma, common hepatic duct, duplication cyst, gastric heterotopia, liver fibrosis
Pubmed
Web of science
Create date
07/09/2017 10:49
Last modification date
20/08/2019 13:23
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