Tubular adenoma of the common bile duct with uptake in 18F‑FDG PET: A case report

Hokonohara,Kentaro; Noda,Takehiro; Hatano,Hisanori; Takata,Akihiro; Hirota,Masashi; Oshima,Kazuteru; Tanida,Tsukasa; Komori,Takamichi; Morita,Shunji; Imamura,Hiroshi; Iwazawa,Takashi; Akagi,Kenzo; Hayashi,Shiro; Inada,Masami; Adachi,Shiro; Dono,Keizo

doi:10.3892/mco.2015.676

Tubular adenoma of the common bile duct with uptake in 18F‑FDG PET: A case report

Authors:
- Kentaro Hokonohara
- Takehiro Noda
- Hisanori Hatano
- Akihiro Takata
- Masashi Hirota
- Kazuteru Oshima
- Tsukasa Tanida
- Takamichi Komori
- Shunji Morita
- Hiroshi Imamura
- Takashi Iwazawa
- Kenzo Akagi
- Shiro Hayashi
- Masami Inada
- Shiro Adachi
- Keizo Dono
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Affiliations: Department of Surgery, Toyonaka Municipal Hospital, Osaka 560‑8565, Japan, Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka 560‑8565, Japan, Department of Pathology, Toyonaka Municipal Hospital, Osaka 560‑8565, Japan
Published online on: November 9, 2015 https://doi.org/10.3892/mco.2015.676
Pages: 35-38
Copyright: © Hokonohara et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

A 64‑year‑old man presented with epigastric discomfort and nausea. Laboratory analyses revealed increased levels of total and direct bilirubin, and increased levels of aminotransferases. Computed tomography revealed the presence of a mass in the distal common bile duct. Endoscopic retrograde cholangiopancreatography and intraductal ultrasonography revealed a 25 mm filling defect in the distal common bile duct, and biopsy of the lesion disclosed the presence of tubular adenoma. Using fluorine‑18 fluorodeoxyglucose positron emission tomography (18F‑FDG PET) revealed an increased accumulation of the tracer in the lesion, with a maximum standard uptake value (SUVmax) of 3.3. The patient received a pylorus‑preserving pancreatoduodenectomy. The histopathological examination revealed a tubular adenoma with low‑grade atypia. The patient remains alive 15 months following the surgery, with no evidence of recurrence of the adenoma. 18F‑FDG PET has been successfully applied in clinical practice to detect a wide variety of tumor types, including lymphoma, lung, colon and bile duct cancer. In the present study, a case of bile duct adenoma with low‑grade atypia was reported, revealing the uptake of 18F‑FDG. 18F‑FDG PET may be able to detect premalignant tumors of the bile duct, although whether 18F‑FDG PET is able to differentially discriminate between diagnoses of adenoma and carcinoma of the bile duct remains to be fully elucidated, and the assessment of further case studies is required.

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1	Kim BS, Joo SH and Joo KR: Carcinoma in situ arising in a tubulovillous adenoma of the distal common bile duct: A case report. World J Gastroenterol. 14:4705–4708. 2008. View Article : Google Scholar : PubMed/NCBI
2	Fletcher ND, Wise PE and Sharp KW: Common bile duct papillary adenoma causing obstructive jaundice: Case report and review of the literature. Am Surg. 70:448–452. 2004.PubMed/NCBI
3	Abraham SC, Lee JH, Hruban RH, Argani P, Furth EE and Wu TT: Molecular and immunohistochemical analysis of intraductal papillary neoplasms of the biliary tract. Hum Pathol. 34:902–910. 2003. View Article : Google Scholar : PubMed/NCBI
4	Zen Y, Fujii T, Itatsu K, Nakamura K, Minato H, Kasashima S, Kurumaya H, Katayanagi K, Kawashima A, Masuda S, et al: Biliary papillary tumors share pathological features with intraductal papillary mucinous neoplasm of the pancreas. Hepatology. 44:1333–1343. 2006. View Article : Google Scholar : PubMed/NCBI
5	Kim KM, Lee JK, Shin JU, Lee KH, Lee KT, Sung JY, Jang KT, Heo JS, Choi SH, Choi DW and Lim JH: Clinicopathologic features of intraductal papillary neoplasm of the bile duct according to histologic subtype. Am J Gastroenterol. 107:118–125. 2012. View Article : Google Scholar : PubMed/NCBI
6	Kluge R, Schmidt F, Caca K, Barthel H, Hesse S, Georgi P, Seese A, Huster D and Berr F: Positron emission tomography with [(18)F]fluoro-2-deoxy-D-glucose for diagnosis and staging of bile duct cancer. Hepatology. 33:1029–1035. 2001. View Article : Google Scholar : PubMed/NCBI
7	Hasebe T, Sakamoto M, Mukai K, Kawano N, Konishi M, Ryu M, Fukamachi S and Hirohashi S: Cholangiocarcinoma arising in bile duct adenoma with focal area of bile duct hamartoma. Virchows Arch. 426:209–213. 1995. View Article : Google Scholar : PubMed/NCBI
8	Serafini FM and Carey LC: Adenoma of the ampulla of Vater: A genetic condition? HPB Surg. 11:191–193. 1999. View Article : Google Scholar : PubMed/NCBI
9	Sato T, Konishi K, Kimura H, Maeda K, Yabushita K, Tsuji M and Miwa A: Adenoma and tiny carcinoma in adenoma of the papilla of Vater - p53 and PCNA. Hepatogastroenterology. 46:1959–1962. 1999.PubMed/NCBI
10	Genc H, Haciyanli M, Tavusbay C, Colakoglu O, Aksöz K, Unsal B and Ekinci N: Carcinoma arising from villous adenoma of the ampullary bile duct: Report of a case. Surg Today. 37:165–168. 2007. View Article : Google Scholar : PubMed/NCBI
11	Takashima M, Ueki T, Nagai E, Yao T, Yamaguchi K, Tanaka M and Tsuneyoshi M: Carcinoma of the ampulla of Vater associated with or without adenoma: A clinicopathologic analysis of 198 cases with reference to p53 and Ki-67 immunohistochemical expressions. Mod Pathol. 13:1300–1307. 2000. View Article : Google Scholar : PubMed/NCBI
12	Kaiser A, Jurowich C, Schönekäs H, Gebhardt C and Wünsch PH: The adenoma-carcinoma sequence applies to epithelial tumours of the papilla of Vater. Z Gastroenterol. 40:913–920. 2002. View Article : Google Scholar : PubMed/NCBI
13	Schlitter AM, Born D, Bettstetter M, Specht K, Kim-Fuchs C, Riener MO, Jeliazkova P, Sipos B, Siveke JT, Terris B, et al: Intraductal papillary neoplasms of the bile duct: Stepwise progression to carcinoma involves common molecular pathways. Mod Pathol. 27:73–86. 2014. View Article : Google Scholar : PubMed/NCBI
14	Sturgis TM, Fromkes JJ and Marsh W Jr: Adenoma of the common bile duct: Endoscopic diagnosis and resection. Gastrointest Endosc. 38:504–506. 1992. View Article : Google Scholar : PubMed/NCBI
15	Munshi AG and Hassan MA: Common bile duct adenoma: Case report and brief review of literature. Surg Laparosc Endosc Percutan Tech. 20:e193–e194. 2010. View Article : Google Scholar : PubMed/NCBI
16	Kubota K: From tumor biology to clinical Pet: A review of positron emission tomography (PET) in oncology. Ann Nucl Med. 15:471–486. 2001. View Article : Google Scholar : PubMed/NCBI
17	Bomanji JB, Costa DC and Ell PJ: Clinical role of positron emission tomography in oncology. Lancet Oncol. 2:157–164. 2001. View Article : Google Scholar : PubMed/NCBI
18	Kitamura K, Hatano E, Higashi T, Seo S, Nakamoto Y, Narita M, Taura K, Yasuchika K, Nitta T, Yamanaka K, et al: Prognostic value of (18)F-fluorodeoxyglucose positron emission tomography in patients with extrahepatic bile duct cancer. J Hepatobiliary Pancreat Sci. 18:39–46. 2011. View Article : Google Scholar : PubMed/NCBI
19	Yamada H, Hosokawa M, Itoh K, Takenouchi T, Kinoshita Y, Kikkawa T, Sakashita K, Uemura S, Nishida Y, Kusumi T and Sasaki S: Diagnostic value of ¹⁸F-FDG PET/CT for lymph node metastasis of esophageal squamous cell carcinoma. Surg Today. 44:1258–1265. 2014. View Article : Google Scholar : PubMed/NCBI
20	Nishiyama Y, Yamamoto Y, Kimura N, Miki A, Sasakawa Y, Wakabayashi H and Ohkawa M: Comparison of early and delayed FDG PET for evaluation of biliary stricture. Nucl Med Commun. 28:914–919. 2007. View Article : Google Scholar : PubMed/NCBI
21	Choi EK, Yoo IeR, Kim SH, O JH, Choi WH, Na SJ and Park SY: The clinical value of dual-time point 18F-FDG PET/CT for differentiating extrahepatic cholangiocarcinoma from benign disease. Clin Nucl Med. 38:e106–e111. 2013. View Article : Google Scholar : PubMed/NCBI
22	Annunziata S, Caldarella C, Pizzuto DA, Galiandro F, Sadeghi R, Giovanella L and Treglia G: Diagnostic accuracy of fluorine-18-fluorodeoxyglucose positron emission tomography in the evaluation of the primary tumor in patients with cholangiocarcinoma: A meta-analysis. BioMed Res Int. 2014:2476932014. View Article : Google Scholar : PubMed/NCBI
23	Albazaz R, Patel CN, Chowdhury FU and Scarsbrook AF: Clinical impact of FDG PET-CT on management decisions for patients with primary biliary tumours. Insights Imaging. 4:691–700. 2013. View Article : Google Scholar : PubMed/NCBI
24	van Kouwen MC, Nagengast FM, Jansen JB, Oyen WJ and Drenth JP: 2-(18F)-fluoro-2-deoxy-D-glucose positron emission tomography detects clinical relevant adenomas of the colon: A prospective study. J Clin Oncol. 23:3713–3717. 2005. View Article : Google Scholar : PubMed/NCBI
25	Yasuda S, Fujii H, Nakahara T, Nishiumi N, Takahashi W, Ide M and Shohtsu A: 18F-FDG PET detection of colonic adenomas. J Nucl Med. 42:989–992. 2001.PubMed/NCBI
26	Dong A, Dong H, Zhang L and Zuo C: F-18 FDG uptake in borderline intraductal papillary neoplasms of the bile duct. Ann Nucl Med. 26:594–598. 2012. View Article : Google Scholar : PubMed/NCBI
27	Wakabayashi H, Akamoto S, Yachida S, Okano K, Izuishi K, Nishiyama Y and Maeta H: Significance of fluorodeoxyglucose PET imaging in the diagnosis of malignancies in patients with biliary stricture. Eur J Surg Oncol. 31:1175–1179. 2005. View Article : Google Scholar : PubMed/NCBI
28	Anderson CD, Rice MH, Pinson CW, Chapman WC, Chari RS and Delbeke D: Fluorodeoxyglucose PET imaging in the evaluation of gallbladder carcinoma and cholangiocarcinoma. J Gastrointest Surg. 8:90–97. 2004. View Article : Google Scholar : PubMed/NCBI