Case of the Month
73 year old female patient with neurofibromatosis (von Recklinghausen)
Jaundice without pain or other symptoms
The jaundice was caused by a tumor mass at Vaters papil with obstruction of the common bile duct and to a lesser degree of the pancreatic duct.
An endoscopy failed because the endoscope could not reach the papil. The patient was referred to a university center.
The mass proved to be a neuro endocrine tumor of Vaters papil. This is a fairly uncommon mass but is seen more frequently in patients with neurofibromatosis. Patient underwent a Whipple procedure