RESUMO
Biliary Schwannoma is an uncommon tumor in the digestive system and extremely rare in the bile duct. We report 48 year-old male with an incidentally found in the CT, a tumor in the hepatic hilum (3.2 cm), abutting the first portion of the duodenum, without common bile duct obstruction or lymphadenopathy. The patient was asymptomatic and had normal tumor markers. The endoscopic ultrasound (EUS) demonstrated contact between the tumor, common bile duct and right hepatic artery and the biopsy suggested of mesenchymal tumor. Tumor board recommended excision of the tumor, due to the risk of malignancy and biliary obstruction. The tumor was resected through laparoscopic approach, with a Roux-en-Y hepatico-jejunostomy. The histological report showed a biliary Schwannoma (positivity for S100 and focal GFAP), which infiltrated the external wall of the bile duct, without affecting the cystic duct, surgical margins were free of neoplasia.
Assuntos
Neoplasias dos Ductos Biliares , Colestase , Neurilemoma , Masculino , Humanos , Pessoa de Meia-Idade , Ductos Biliares , Neoplasias dos Ductos Biliares/cirurgia , Colestase/cirurgia , Ducto Colédoco , Neurilemoma/complicações , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgiaAssuntos
Humanos , Masculino , Adulto , Neurilemoma/diagnóstico por imagem , Neurilemoma/diagnóstico , Neurilemoma/terapia , Ductos Biliares/patologia , Neoplasias dos Ductos Biliares/diagnóstico por imagem , Neoplasias dos Ductos Biliares/diagnóstico , Neoplasias dos Ductos Biliares/terapia , Colestase/diagnóstico por imagem , Colestase/diagnóstico , Colestase/terapia , ColangiocarcinomaRESUMO
La pica se define como la ingesta de sustancias no nutritivas de naturaleza orgánica o inorgánica durante más de un mes. Este trastorno puede ser secundario a enfermedades neurológicas o psiquátricas (retraso mental, autismo, trastornos de la personalidad), pero también puede ser la expresión de déficit nutricional, como la ferropenia. Ante una ferropenia refractaria siempre se ha de pensar en un cuadro malabsortivo subyacente. Se presenta el caso clínico de un niño en edad escolar con pica secundaria a una enfermedad celíaca
Pica is defined as the ingestion of non-nutritive substances for more than a month. This disorder may be secondary to neurologic or psychiatric illnesses (mental retardation, autism, personality disorders), but it can also be the expression of nutritional deficit, such as iron deficiency. In cases of refractory iron deficiency an underlying malabsorptive condition should be ruled out. Here we present the case of a school-age child diagnosed with pica related to celiac disease
