Granular cell tumor of the biliary system

Area of Science:

• Oncology
• Gastroenterology
• Pathology

Background:

• Granular cell tumors (GCT) are rare, benign neoplasms originating from Schwann cells, found across various body locations.
• Biliary system involvement by GCT is infrequent, predominantly observed in black females in their fourth decade of life.

Observation:

• Two cases of obstructive jaundice caused by extrahepatic biliary tree GCT are presented.
• Literature review on biliary GCT and their management strategies is included.

Findings:

• Surgical intervention varied based on GCT location: local excision with Roux-y-hepaticojejunostomy for common bile duct obstruction, and pancreaticoduodenectomy for GCT involving the ampulla and adjacent pancreas.
• GCT of the extrahepatic biliary system should be considered in the differential diagnosis for black females presenting with obstructive jaundice.

Implications:

• Local excision with cholecystectomy and biliary reconstruction is the recommended treatment for biliary GCT.
• While primary biliary anastomosis is ideal, choledochojejunostomy or hepaticojejunostomy may be necessary.
• Pancreaticoduodenectomy is rarely indicated for GCT located in the distal common bile duct.