Journal Club: Unusual case of biliary neuroendocrine tumor

Magnetic resonance cholangiopancreatograph,y followed by contrast administration, showed a well-defined lesion in the region of the proximal common hepatic duct which was mildly hyperintense. The lesion was seen extending into the adjacent portions of the hepatic ducts, resulting in dilation of the proximal intrahepatic biliary tree.

A diagnosis of cholangiocarcinoma was raised. The patient was scheduled to undergo an extended right hepatectomy. After ensuring adequate left liver lobe volume, the patient proceeded with an extended right hepatectomy and hepaticojejunostomy.

Pathological and immunohistological examination led to a final diagnosis of grade 2 periductal infiltrating neuroendocrine with no lymphovascular infiltration. A whole-body positron emission tomography-computed tomography (CT) scan, which was done 18 months after right extended hepatectomy and hepaticojejunostomy, revealed no definite evidence of somatostatin receptor (SSTR)-positive disease anywhere in the whole-body survey.

Hence, the authors concluded that biliary NETs are rare. However, in patients presenting with obstructive jaundice, biliary NETs should be kept in mind as a probable diagnosis, especially when typical risk factors for cholangiocarcinoma are not present.

Ref: Sherene H, Kasi V, Mahadevan GS, Rajasekaran S, Mehta SS. Unusual case of biliary neuroendocrine tumor. Case Rep Clin Radiol. 2025;3:35-8. doi: 10.25259/CRCR_104_2023