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Extrahepatic biliary schwannoma.

Yumiko Honjo1, Yoshimasa Kobayashi, Toshifumi Nakamura

  • 1Department of Gastroenterology, Hamamatsu Medical Center, Hamamatsu, Shizuoka, Japan.

Digestive Diseases and Sciences
|January 7, 2004
PubMed
Summary

A rare benign schwannoma (a nerve sheath tumor) was found in the common bile duct of a 47-year-old woman, causing obstructive jaundice. This case highlights an unusual location for this type of tumor.

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Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Oncology

Background:

  • Schwannomas are typically found in peripheral nerves and rarely occur in the biliary tract.
  • Extrahepatic biliary schwannomas are exceptionally rare, with limited documented cases.

Observation:

  • A 47-year-old Japanese woman presented with obstructive jaundice due to a tumor involving the common bile duct.
  • Radiological imaging suggested a nonepithelial tumor.
  • The tumor exhibited a dumbbell shape, extending both inside and outside the common bile duct wall.

Findings:

  • Microscopic examination revealed spindle-shaped cells with nuclear palisading and lymphoid aggregates, characteristic of schwannoma.
  • Immunohistochemistry confirmed tumor cells were positive for S-100 protein.

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  • The final diagnosis was a benign schwannoma of the common bile duct, with distinct extraductal solid/microcystic and intraductal cystic components.

    • Implications:

    • This case expands the known spectrum of schwannoma presentation, particularly in the biliary system.
    • The findings suggest that schwannomas, while rare, should be considered in the differential diagnosis of nonepithelial tumors of the common bile duct.
    • The tumor's morphology shared similarities with gastrointestinal schwannomas, suggesting potential shared developmental or biological pathways.