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Case of the Month

July 2013

Patient Data: 73 year old female patient with neurofibromatosis (von Recklinghausen)

Clinical Info: Jaundice without pain or other symptoms


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Liver with dilatated intrahepatic bile ducts


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Another image of the liver with dilatated bile ducts


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The common bile duct is massively dilatated and measures 3,5 cm


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There is a large gallbladder with a layer of thickened bile


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Detail of the common bile duct ending in a rounded mass


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Another image of the common bile duct and tumor mass


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Image of the pancreatic duct that is slightly dilatated


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Another image of the rounded mass at the papil


50732-NET_1.swf CT scan

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


Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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