Contrast-enhanced ultrasound characteristics for the diagnosis of biliary adenofibroma

Introduction

Biliary adenofibroma (BAF), first described in 1993 by Tsui et al., is a rare entity originating from the bile duct epithelium (Tsui et al. Am J Surg Pathol 1993; 17: 186–192). To date, fewer than 50 cases with a predominantly benign course have been published. However, a transformation to an invasive carcinoma has also been reported in a few cases (Sturm et al. Surg Case Reports 2019; 5: 104). The etiology of BAF is not yet clearly understood. Histologically, tubulocystic glandular structures and solid, fibroblastic stroma are typical features (Arnason et al. Am J Surg Pathol 2017; 41: 499–505). Diagnosis of BAF is challenging because symptoms arise only in cases with large, advanced tumors. Specific clinical or laboratory findings have not been established. Therefore, the majority of BAFs are detected in asymptomatic patients by ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI), but definite diagnosis requires tissue sampling. The treatment of choice is complete surgical resection. Detailed features of contrast-enhanced imaging of BAF have only been described in a few cases for CT and MRI, but the value of contrast-enhanced ultrasound (CEUS) for the diagnosis of BAF has not been evaluated so far.

Publication History

Received: 28 August 2023

Accepted after revision: 02 November 2023

Article published online:
11 December 2023